DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205260

Torsion in a massive hematosalpinx with a functional rudimentary horn: a rare cause of acute abdomen in adolescence, managed laparoscopically

Arpita De, Renu Misra, Abhinav Jain

Abstract


Congenital anomalies of the female genital tract may remain undiagnosed till adolescence. Unicornuate uterus with a rudimentary horn is rare and found in 1 in 100000 women. A functional rudimentary horn may cause hematometra, hematosalpinx, endometriosis and its complications. This is a case of a 13-year-old girl who had a hematometra in a functional rudimentary horn and a hematosalpinx with torsion giving rise to an acute abdomen and a 16-week mass abdomen. Laparoscopy was done followed by detorsion, salpingectomy and transection of the rudimentary horn. This article should sensitize the need to correct the anomaly while preserving the reproductive potential of the girl. A review of the salient points of laparoscopy in such cases have been further discussed.


Keywords


Acute abdomen in adolescent girls, Unicornuate uterus with functional rudimentary horn, Laparoscopic rudimentary horn excision

Full Text:

PDF

References


Rani A, Kumari M, Shipra. A Case of Non-communicating Uterine horn containing Functional Endometrium. Gynecol Obstet. 2015;5:9.

Guthrie BD, adler MD, powell EC. Incidence and trends of pediatric ovarian torsion hospitalizations in the United states, 2000-2006. Pediat. 2010;125:532-8.

Reichman D, Laufer MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: A Review. Fertil Steril. 2009;91(05):1886-94.

Chandler TM, Machan LS, Cooperberg PL, Harris AC, Chang SD. Mullerian duct anomalies: from diagnosis to intervention. Br J Radiol. 2009;82(984):1034‐42.

Grimbizis. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28(8):2032-44.

Paul PG, Chopade G, Das T, Dhivya N, Patil S, Thomas M. Accessory cavitated uterine mass: a rare cause of severe dysmenorrhea in young women. J Minim Invas Gynecol. 2015;22(7):1300-3.

Celik A. Long-term results of conservative management of adnexal torsion in children. J Pediatr Surg. 2005;40:704-8.

Gupta N, Nigam A, Tripathi R, De A. Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl. Brit Med J Case Rep. 2018.

Chandler TM, Machan LS, Cooperberg PL, Harris AC, Chang SD. Mullerian duct anomalies: from diagnosis to intervention. Br J Radiol. 2009;82(984):1034‐42.

Grimbizis. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28(8):2032-44.

Nigam A, De A, Jain A, Gupta N, Tripathi R. Ovarian torsion in a 4-year-old girl: A Rare occurrence. J Minim Invas Gynecol. 2020;27(2); 244-5.

Chundawat R, Rastogi R, Tak A. Torsion of gravid horn of bicornuate uterus: a rare case report. Int J Reprod Contracept Obstet Gynecol. 2016;5:2428-30.

Amara DP, Nezhat F, Giudice L, Nezhat C. Laparoscopic management of a noncommunicating uterine horn in a patient with an acute abdomen. Surg Laparosc Endosc. 1997;7(1):56‐9.

Mabrouk M, Arena A, Zanello M, Raimondo D, Seracchioli R. Unicornuate uterus with noncommunicating functional horn: diagnostic workup and laparoscopic horn amputation. Fertil Steril. 2020;113(4):885-7.

Faller E, Baldauf JJ, Becmeur F, Lehn A, Akladios CY, Lecointre L. Laparoscopic Management of a Rudimentary Uterine Horn. J Minim Invasive Gynecol. 2018;25(5):769-70.

Jan H, Katesmark M, Ghai V. A Stepwise Approach to Laparoscopic Excision of a Noncommunicating Rudimentary Horn. J Minim Invas Gynecol. 2019;26(4):600-1.