Imperforate Hymen: An Easily Missed Diagnosis of Low Back Pain In Adolescent Female

無孔處女膜：在青春期少女之下背痛很容易被遺漏的診斷

王天成(Tien Chen Wang) ； 毛宏鑫(Hung Hsin Mo)

《童綜合醫學雜誌》 12卷2期 (2018/12) Pp. 129-132

https://doi.org/10.3966/2071359220181212020010

摘要

Imperforate hymen in adolescent girls usually presents as cyclic (monthly) lower abdominal pain with primary amenorrhea. Herein we report a case of imperforate hymen presenting solely as low back pain (LBP) that was initially treated as a lumbar strain. Limited literature is present on back pain as a presenting symptom of imperforate hymen. LBP is a common complaint in the pediatric population and causes of this symptom are varied. However, imperforate hymen has not been mentioned as a differential diagnosis of LBP in reviews present on pediatric back pain. This peculiar clinical presentation makes a prompt diagnosis challenging and can easily go undetected. However, delayed diagnosis can lead to complications such as endometriosis or ruptured hematosalpinx. We believe that this rare manifestation is significant and should be highlighted because misdiagnosis in such cases can lead to disastrous consequences.

關鍵字

Imperforate hymen ； Low back pain ； Hematocolpos ； Hematometria

並列摘要

在青春期少女，無孔處女膜經常以週期性下腹痛合併原發性無月經來表現。在這份病例報告裡，我們提出以下背痛為唯一症狀表現的無孔處女膜病例, 起初被當作腰部扭傷來處置。至今只有少數的文獻報導過以下背痛表現的無孔處女膜病例。在兒童族群裡，下背痛是常見的主訴。此一症狀的病因繁多，然而在兒童下背痛回顧的文獻裡並沒有把無孔處女膜列入其鑑別診斷。因此要對於這種不尋常的表現做出迅速的診斷不僅是困難的而且是容易遺漏的。延遲診斷可能導致子宮內膜異位或輸卵管積血併發破裂。我們認為這種罕見的表現很重要且需要再次強調，因為此種病例的誤診很可能導致災難性的後果。

並列關鍵字

無孔處女膜 ； 下背痛 ； 陰道積血 ； 子宮積血