pediatric gynecology

You are called to the neonatal intensive care unit to evaluate a 16-hour-old girl with progressive abdominal distention and respiratory distress requiring 6L HFNC. On examination she has a distended abdomen with a palpable mass above the umbilicus. An abdominal radiograph demonstrates a rounded hypoechoic mass extending from the pelvis to the upper abdomen. There has been no urine output since birth despite intravenous fluids for the last 4 hours. The genitourinary examination is shown below. What is the best next step in her management? a Diverting colostomy for anorectal malformation b Suprapubic bladder catheterization c Incision of the imperforate hymen …

A 6-year-old female presents with sudden oneset of right sided abdominal pain. Her mom notes the patient has a history of polycystic ovarian syndrome. US reveals an asymmetrically enlarged right ovary with adjacent right adnexal soft tissue swirling concerning for ovarian torsion. She is brought to the operating room where the right ovary had a 180 degree torsion. After successful detorsion the remainder of the pelvis is examined and shown below. What is the best next step in the management of this patient? a [size=6]Oopexy of bilateral ovaries b Detorsion of the left ovary c External pelvic examination d Ovarian biopsy e CT scan of the abdomen/pelv…

[size=20px]A fourteen year old girl presents to the emergency department with a six month history of chronic, cyclic abdominal pain. She has not yet begun menstruating. She is Tanner Stage 4 with a palpable nontender lower abdominal mass and a bluish-tinged bulge at the introitus. An ultrasound (US) examination reveals a 10 cm fluid-filled mass arising from the pelvis thought to be a distended uterus. What is the best next step in this girl’s management? a Pelvic MRI b EUA with hymenectomy c EUA with circular hymenotomy d Percutaneous drainage of pelvic mass[/size]

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A 14-year old girl had a right dysplastic kidney removed as an infant. She started menstruating at age 13 and now has progressive severe dysmenorrhea. US shows normal ovaries and a large midline cystic mass as shown.What is your suspicion and how will you confirm it?

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An otherwise healthy 2 month old girl was referred to the outpatient office for the vaginal finding seen below. The next best step in managing this vaginal anomaly is A pelvic ultrasound B vaginoscopy and vaginostomy C serum electrolytes D topical estrogen E systemic steroids​

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see video link in second post 1 year old born with hydrocolpos duo to high vaginal atresia with vaginal septum ,initially vaginostomy was done at neonatal period

A 12-year old girl presents with dysmenorrhea. Menarche started one year ago, but she has been bleeding heavily and irregularly for the last 6 months. She had been taking oral contraceptives, but her bleeding has not been controlled. Her ultrasound and CT show a large pelvic mass. . . [size=20px]Serum levels of Inhibin A and B are elevated. At operation, a 20 cm right ovarian mass is seen. It does not involve the ipsilateral tube. Peritoneal washings are obtained. No other lesion is noted. The most appropriate management for this ovarian tumor is: A Ovarian sparing mass excision B Uniteral salpingo-oophorectomy C Unilateral oophorectomy and endometrial…

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