Obstet Gynecol Sci.  2016 May;59(3):249-252. 10.5468/ogs.2016.59.3.249.

Delayed retropneumoperitoneum following vaginal laceration in a 7-year-old girl

• Min KJ
• Im H
• Lee S
• Hong JH
• Song JY
• Lee JK
• Lee NW

• KMID: 2351794
• DOI: http://doi.org/10.5468/ogs.2016.59.3.249

Abstract

We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain. A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. Initially, the patient's vital sign and perineum were within normal range. Because the patient's vital signs became unstable 12 hours after vaginal injury, we carried out abdomino-pelvic computed tomography resulting in retropneumoperitoneum. Arterial bleeding from vaginal lateral wall was founded and controlled by electrocoagulation. No damage to the rectum was laparoscopically confirmed. A diagnostic laparoscopy, not laparotomy, should be considered in cases of retropneumoperitoneum with an ambiguous cause first.

Keyword

Child; Laceration; Retropneumoperitoneum; Vagina

MeSH Terms

Child*
Electrocoagulation
Emergency Service, Hospital
Female*
Hemorrhage
Humans
Lacerations*
Laparoscopy
Laparotomy
Perineum
Rectum
Reference Values
Retropneumoperitoneum*
Vagina
Vital Signs
Water
Water

Figure

• 

  Fig. 1 Abdomino-pelvic computed tomography showing extensive pneumoretroperitoneum around the rectum. (A) Transverse section and (B) coronal section. b, bladder; R, retropneumoperitoneum; r, rectum.

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