Haematometrocolpos due to transverse vaginal septum with distal atretic vagina

Description 

A 15-year-old girl presented with cyclical pelvic, lower abdominal pain and cramping beginning at age 13. She had not yet had onset of menarche and no history of sexual intercourse. On examination, she presented with lower abdominal distension, which felt like a firm mass extending up to the umbilicus and into the pelvic cavity. Abdominal ultrasound showed an ectopic right kidney in the paramedian position at the level of the umbilicus. Ultrasound also showed a large midline cystic structure located between the urinary bladder and rectum, containing low-level homogenous echoes suggestive of blood products. MRI confirmed the ultrasound findings as it showed the endometrial, endocervical and vaginal canal were distended by low-signal material (T2 and short-tau inversion recovery). Images appeared hyperintense on T1W1, suggestive of haematometrocolpos due to a complete transverse vaginal septum at the level of the pubic symphysis, distal portion of vagina was atretic (

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