11 years old malay girl, primary amenorrhea, presented multiple times to casualty for recurrent AUR which relieved after insertion of urinary catheterization. She had advised to be admitted on last presentation for further workup but her father requested AOR (at own risk) discharge in view of work problems. She presented again with acute urinary retention for the past 1/7. This is associated with abdominal pain and distension. Patient otherwise well, no fever, no altered bowel no recent history of fall or trauma.
O/E; well build,
Vital sign monitoring shows
US abdomen shows: Enlarged bladder up to the umbilicus CBD was inserted however urine out is only in tubing.
Repeat bedside ultrasound shoes CBD baloon is “outside” the “bladder”.
She was then referred to the gynaecology team where vaginal examinations reveal IMPERFORATED HYMEN She was then planned for elective operations in few days.