The girl has not yet come to menstruation in the second year of junior high school, and the abdominal pain is unbearable to miss the final exam, but it is because the "big aunt" is blocked

Ms. C in Hangzhou has been very upset recently, the 13-and-a-half-year-old daughter has not had menstruation, but almost all other girls of the same age in the class have come, why hasn't the daughter?

But she thought again and again, maybe her daughter developed late, so she didn't care about it.

I don't admit it, 5 days ago, I suddenly cried out that my stomach hurt, and when I was serious, my urination was not smooth. Near the end of the term, in order not to affect the review, Ms. C and Yan Yan wanted to survive the end of the term. Endured for 3 days, the abdominal pain of the words has not disappeared, On Sunday Ms. C took her to the nearby community hospital for examination, B ultrasound prompted the pelvic cavity to see 13.3cm × 9.5cm lump, larger than the fetal head, the community hospital can not deal with it, it is recommended to go to the higher hospital for treatment.

Preoperative pelvic MR: a large mass may be seen

Both mother and daughter were anxious, and rushed to the emergency department of the Children's Hospital Affiliated to Zhejiang University School of Medicine, and the emergency doctor immediately contacted Dr. Chen Dandan of the Department of Pediatric and Adolescent Gynecology for consultation after receiving the treatment. Dr. Chen asked about the medical history to learn that the future menstruation so far, the physical examination found that the hymen was slightly puffed out, not obvious purple-blue, the anal examination of the anterior wall of the rectum can reach a huge mass, high tension, tenderness is obvious, comprehensively considered as "lower vaginal atresia may be", the need for emergency surgery to relieve obstruction, relieve pain, reduce the possibility of endometriosis.

But the next day there will be a final exam, what to do? Yan Yan was at the top of the class, and after working hard for a semester, he wanted to achieve good results at the end of the semester. She felt that her abdominal pain had eased more than before, and did not affect walking, and strongly requested to suspend the operation for 2 days.

Dr. Chen Dandan and Dr. Zhang Junwei, taking into account the current specific situation of Yan Yan, decided to improve the relevant preoperative examinations that night, explain the preoperative precautions, and arrange emergency surgery as soon as the speech examination is over on Tuesday. Just in case, the two doctors repeatedly confessed to Ms. C and Yan that if the abdominal pain worsened during this period, they would have to come to the hospital for emergency surgery immediately.

It was not a wish, Monday night Yan Yan stomach pain worsened, the pain was unbearable, had to come to the hospital in the early morning, unfortunately Yan Yan still could not survive to the final exam, Tuesday emergency department surgery.

What shocked the doctor was that 600ml-700ml of blood was drained during the operation, and it is difficult to imagine that there is about 1 year or so of menstrual blood accumulated in the child's vagina, no wonder the abdominal pain is unbearable, and can not persist until the end of the exam.

"If parents had brought their children to developmental assessment check-ups earlier, this situation could have been avoided. It's a shame that I can't successfully take the final exam. Sun Liying, deputy director of the Department of Pediatric Gynecology, sighed.

Sun Liying said that the breasts began to develop, indicating that girls have entered puberty, and it generally takes 2-3 years from the beginning of breast development to the beginning of menstruation. If after this period, the child has not come to menstrual leave, it is necessary to go to the pediatric adolescent gynecology department for a comprehensive assessment to understand the child's development level, rule out the possibility of similar congenital genital tract obstruction, and avoid emergency need emergency surgery to delay the child's education.

Deputy Director Sun Liying introduced that vaginal atresia is caused by abnormal development of the genitourinary sinuses and the end of the Miaoler duct without the formation of a penetrating vagina, which is a congenital malformation of the reproductive tract. Patients with vaginal atresia have normal chromosomal and gonadal development, so the secondary sex characteristics are normal, infancy and adolescence are rarely found, and symptoms appear after puberty due to obstruction of menstrual blood outflow.

Deputy Director Sun Liying said that for such diseases, surgical removal of obstruction treatment is the only effective treatment. "When children enter puberty, they must not only pay attention to breast development, height and bone age, but also pay attention to reproductive tract development, and do routine examinations in the pediatric adolescent gynecology department to find various problems in girls' sexual development in time and avoid the recurrence of regrets such as speech."

(Orange Persimmon Interactive City Express reporter Yu Xixi)