Pyometrocolpos in an 18-Month-Old Child: A Rare Cause of Acute Abdomen

Acute abdomen secondary to pyometrocolpos as a result of microperforate hymen in an 18-month-old child is extremely rare to witness. Such a child was admitted with a history of poor appetite, lethargy, high-grade febrile episodes, frequent urination, and multiple episodes of vomiting in seven days. There was no relief of symptoms on oral antibiotics. On careful examination, the abdomen was distended. A suprapubic bulge with mild tenderness was palpable. Genital examination revealed the absence of vaginal introitus with a bulging membrane. Ultrasound showed the presence of echogenic contents within the dilated uterine and vaginal cavities. An emergency hymenotomy drained 150 cc of malodorous purulent material. Symptoms were relieved post-surgery. This, to our knowledge, being the youngest case of microperforate hymen presenting with acute abdomen makes it worth reporting.