Perimenopausal amenorrhea with cervical atresia and hematotrachelos

Obstruction of the lower female genital tract leading to proximal dilatation and development of hematotrachelos is most commonly a result of congenital abnormalities such as an imperforate hymen, a complete transverse vaginal septum, or rarely, cervical atresia. Acquired hematotrachelos is rare, and the possible etiology includes iatrogenic trauma to the uterocervix such as cervical surgery, dilation and curettage, obstetric laceration, cervical or endometrial carcinoma, and radiation therapy. We report an unusual case of a patient in who spontaneously acquired hematotrachelos developed in the perimenopausal period. Combined speculum inspection of the cervix and recognition of transvaginal echographic features assisted the diagnosis. In addition, we tried a new treatment method, using the firm plastic end of an Ipas Karman cannula (6 mm diameter and 6 cm length) with nylon fixation retained for 1 month that resulted in a patent cervical canal.