A 16-year-old female presents with cryptomenorrhea and with normal secondary sexual characters. Investigation of choice is

Correct Answer: Genital exam for out flow obstruction
Description: (C) Genital exam for out flow obstruction # Girls with Imperforate Hymen present with colicky abdominal pain which is often cyclic.> Menarche has not yet set in, however the secondary sexual characters have been well developed.> As vagina gets progressively & increasingly distended with menstrual blood, pressure symptoms follow. Difficulty during micturition finally ends up with urinary retention> On examination a hypogastric or suprapubic bulge is often obvious which may cause discomfort on palpation.> It may be mistaken for a full bladder, ovarian cyst, appendicular mass, matted loops of bowel and omentum, encysted ascites due to tuberculosis, or even pregnancy.> On separation of the labia, a bluish bulging membrane is recognized. Thus the diagnosis of imperforate hymen causing haematocolpos is arrived at a rectal examination reveals the bulge of the vagina anteriorly.> An imperforate hymen causing haematocolpos is not an infrequent clinical entity. It is observed in young girls.
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