Management of three cases of pyometrocolpos due to distal vaginal atresia in infants

Abstract

Children with pyometrocolpos due to distal vaginal atresia may present as acutely ill, with severe obstructive uropathy and septicemia. In such patients the clinical course is markedly improved by urgent drainage of the infected cystic mass, and a temporary drainage procedure is required to allow local findings of infection to subside before definitive surgery. We present a 3 cases one at 2 months and two cases at 4- months of age old females with pyometrocolpos two of them with the above-mentioned clinical course and one of them with typical presentation of Mayer Rokitansky Kuster Houser syndrome (MRKH syndrome) ( is characterized by Mullerian duct structures agenesis, vaginal atresia being the commonest variant) ,presenting and having association of anorectal malformation, Mullerian duct agenesis and renal anomaly , all received urgent laparotomy and drainage through the upper abdominal wall transverse incision (was performed in spite of the high risks of complex drainage procedures and general anesthesia). This drainage did result in dramatically improved clinical status, and findings of local inflammation resolved within 4-6 weeks, which facilitated a later successful definitive surgical procedure.