The perplexing entity of rudimentary uterine horn: a case report of tertiary care center
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243614Keywords:
Uterine anomaly, Unicornuate uterus, Rudimentary horn, Hemi-hysterectomy, Reproductive age group womenAbstract
Congenital uterine anomalies (CUAs) are an uncommon type of female genital malformations caused by abnormal development of Mullerian ducts during embryogenesis. Patients with an obstructive uterine anomaly have a higher risk of developing gynaecological and obstetric complications that may present at menarche or later in life. We present a case of severe dysmenorrhea in a adult reproductive age group women caused by obstructive hematometra in a noncommunicating horn of the unicornuate uterus. A differential diagnosis of a possible anomaly was made using 2-dimensional pelvic ultrasonography, which was later confirmed using MRI that revealed an anomalous uterine cavity with a single left-sided cornua communicating with the cervix and a distended right-sided rudimentary horn. She underwent a right salpingectomy and right oophorectomy with rudimentary horn excision (hemi-hysterectomy), which was successfully managed by laparotomy. This case emphasizes the importance of physicians being cognizant in identifying patients with uterine anomaly to provide appropriate treatment and prevent adverse reproductive outcomes.
Metrics
References
Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011;17(6):761-71.
Akhtar MA, Saravelos SH, Li TC, Jayaprakasan K. Reproductive implications and management of congenital uterine anomalies: scientific impact paper no. 62. BJOG. 2019;127(5):e1-13.
Borah T, Das A, Panda S, Singh S. A case of unilateral dysmenorrhea. J Hum Reprod Sci. 2010;3(3):158-9.
Thapa S, Mohammed A, Chowdhury M, Mensah S. Case report on an unusual presentation of rudimentary uterus. J Univers Surg. 2015;3(3):14.
Hassan MA, Lavery SA, Trew GH. Congenital uterine anomalies and their impact on fertility. Womens Health. 2010;6(3):443-61.
Marcal L, Nothaft MA, Coelho F, Volpato R, Iyer R. Mullerian duct anomalies: MR imaging. Abdom Imaging. 2011;36(6):756-64.
Khati NJ, Frazier AA, Brindle KA. The unicornuate uterus and its variants: clinical presentation, imaging findings, and associated complications. J Ultrasound Med. 2012;31(2):319-31.
Reichman D, Laufer MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2009;91(5):1886-94.
Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, Gordts S, Exacoustos C, Van Schoubroeck D. The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Gynecol Surg. 2015;13(1):116.
Szkodziak P, Woźniak S, Czuczwar P, Paszkowski T, Milart P, Wozniakowska E. Usefulness of three dimensional transvaginal ultrasonography and hysterosalpingography in diagnosing uterine anomalies. Ginekol Pol. 2014;85(5):354.
Arslan T, Bilgiç E, Sentürk MB, Yücel N. Rudimentary uterine horn pregnancy: a mystery diagnosis. Fertil Steril. 2009;92(6):2037-3.
Scheibner K, Kuhn A, Raio L, Brühwiler H, Müller MD. The non-communicating rudimentary horn: diagnostic and therapeutic challenges. Gynecol Surg. 2007;4(3):207-11.
Mengistu K, Bobe T, Tilahun G, Kifle K, Geleta D. Rudimentary horn pregnancy diagnosed after laparotomy. Case Rep Obstet Gynecol. 2020;2020:5816487.
Obeidat RA, Aleshawi AJ, Tashtush NA, Alsarawi H. Unicornuate uterus with a rudimentary non-communicating cavitary horn in association with VACTERL association: case report. BMC Womens Health. 2019;19(1):71.
Reichman D, Laufer MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2009;91(5):1886-94.
Humane A, Agrawal N. Unicornuate uterus with noncommunicating functional horn: a case report. Int J Curr Res. 2020;12(3):10845-7.