Re: Primary Amenorrhea
From: Efrain Ramirez (eramirezt@coqui.net)
Mon Dec 13 04:51:41 2004
Idem
At Sun, 12 Dec 2004, Braun, R. Daniel wrote:
>
>#1
>I assume the CT scan showed bilateral normal kidney function and anatomy.
>
>Dan
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net on behalf of Garry E. Siegel, M.D.
>Sent: Sat 12/11/2004 12:35 AM
>To: Multiple recipients of list OB-GYN-L
>Cc:
>Subject: GYN: Primary Amenorrhea
>14 YO with primary amenorrhea with the following history.
>
>No menses, normal development (i.e. breasts, hair, height, etc.) who
>for around 2 to 3 months has had intermittent crampy abdominal pain.
>
>FP sents her for CT and ultrasound (can't remember which was done
>first).
>
>ultrasound--uterus 16 X 9 X 5 (may not be exactly right but the 16 is!),
>fluid filled, normal adnexa.
>
>CT--fluid filled pelvic mass to the perineum.
>
>Exam (gasp):
>
>Normal gross appearance and hair
>
>Didn't have her take off her shirt/bra, but she looked pretty normal for
>14 (i.e. 14 going on 18!).
>
>Scaphoid abdomen with 18 week size central mass
>
>Genital inspection in stirrups--normal hair/labia and hymen imperforate
>as best I could tell/she would let me but no obvious "pressure" behind
>it.
>
>I think this may be a simple imperforate hymen.
>
>I am debating about:
>
>1. OR trip to open hymen, be ready to lapscope/hysteroscope prn.
>2. Have her see REI primarily for same, so if she has a weirdo
>mullerian abnormality, it is all done at once.
>
>Mom and child are debating with Xmas holidays, soccer tournament, year
>end deducitible all factors to a degree.
>
>Any thoughts?
>
>Garry
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
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