Neonatal hydrometrocolpos secondary to vaginal atresia causing obstructive uropathy and renal dysfunction.
Ahmad Zohud, Hala O Abdallah, Hobab Jehad Odeh et al.
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Case in brief
A preterm female neonate had antenatal ultrasound findings of bilateral enlarged kidneys, ascites, and polyhydramnios. After birth, she developed sepsis and elevated serum creatinine. Abdominal ultrasound and MRI demonstrated a cystic abdominopelvic mass alongside enlarged kidneys. Exploratory laparotomy confirmed congenital vaginal atresia with hydrometrocolpos, causing urinary tract compression and renal dysfunction. After surgical intervention, she stabilized and her renal function improved markedly.
What made this case unusual
Congenital vaginal atresia with hydrometrocolpos presented in the neonatal period and was associated with obstructive uropathy and renal dysfunction, rather than being diagnosed around puberty.
Diagnostic / clinical pearl
In a neonate with a cystic abdominopelvic mass and renal enlargement or dysfunction, consider hydrometrocolpos from congenital vaginal atresia as a potential cause of urinary tract obstruction.