Background: Imperforate hymen though most common female genital tract malformation, remains an uncommon cause of acute urinary retention and abdominal pain in children. Case Report: We present a case of 13 year old pre-menarchal female who presented with acute urinary cyclical suprapubic pain and a lump in abdomen in emergency department. Foleys catheterization was done to relief her urinary retention. On detail examination, she was diagnosed with imperforate hymen and palpable lump in abdomen. Ultrasonography showed it to be hematometrocolpos. Patient underwent hymenotomy and passive drainage of collected menstrual blood. Discussion: Imperforate hymen presents as amenorrhea, recurrent cyclical lower abdominal/pelvic pains, acute urinary retention or palpable lump due to hematometrocolpos.
Conclusion: It is a diagnosis that can easily be overlooked in the fast paced setting of the Emergency Department. It must be included, particularly, in the differential diagnosis of every pre-pubertal young female with abdominal pain or acute urinary retention.