Severe Abdominal Pain Mimicking Appendicitis Caused by Imperforate Hymen: Case Report and Narrative Review

An imperforate hymen is a rare congenital genital anomaly causing menstrual blood retention during puberty. Treatment consists of a simple surgical incision of the hymenal membrane. We present a case of a 14-year-old girl who was admitted to the Emergency Department with severe lower abdominal pain mimicking appendicitis. Medical history revealed a lack of menses and several months of cyclic abdominal pain. Imaging diagnostics confirmed an imperforate hymen with hematometrocolpos. Hymenotomy was performed with full recovery without complications. An imperforate hymen should be considered in the differential diagnosis of abdominal pain in adolescent girls, especially without expected menstruation. Early recognition allows for prompt treatment and prevents complications.