Vulvar Hematoma

Introduction

• Description: Vulvar hematoma is the swelling of one or both labia because of interstitial bleeding, most often after blunt trauma.

• Predominant Age: Most common in childhood and teen years but may occur at any age.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Blunt trauma (straddle injury, sexual abuse, rape, water skiing), vaginal surgery or delivery, varicose veins of vulva.

• Risk Factors: Sports activities; uncommonly, consensual inter-course.

Signs and Symptoms

• Painful swelling of one or both labia. Unilateral and anterior most common with trauma: Mons, clitoral hood, labia minora; most located anterior or lateral to the hymen. Trauma to the hymen or posterior fourchette is uncommon in accidental trauma and suggests, but does not confirm, sexual abuse.

• Dark blue or black discoloration

• Bleeding from vulva if laceration is present

Diagnostic Approach