Case of the Month August 2014

Ultrasound of a 13-year-old Patient with Cyclical Pelvic Pain

Case submitted by Avetis Azizyan, MD and Thomas J. Learch, MD.

History: A 13-year-old Caucasian female presents to the emergency department with months of cyclical pelvic pain and “fullness.” The patient has not started menstruating and is not sexually active. Her medical history is nearly unremarkable except that she was born without a left kidney. This was diagnosed on a fetal ultrasound and is not associated with any adverse health issues.

For a larger image, please click on Pelvic Pain 1 .

Question 1: Sagittal sonographic image of the uterus, cervix and vaginal vault. What is the abnormality and the pathophysiology responsible?

A. Blood / fluid level secondary to vaginal aplasia
B. Blood / fluid level secondary to imperforate vaginal septum
C. Nabothian cysts secondary to mucous gland blockage
D. Pelvic location of left kidney

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