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Haque A, Annas JY. Unidentified chronic pelvic pain due to hematometra non-communicating left horn uterus unicornuate with history of abdominal pregnancy. Int J Surg Case Rep 2024; 117:109435. [PMID: 38461588 PMCID: PMC10940765 DOI: 10.1016/j.ijscr.2024.109435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION This study aimed to characterize unicornuate uterus with noncommunicating horns, an uncommon Müllerian abnormality. With a 0.06 % incidence rate, this disorder can lead to endometriosis linked to retrograde menstruation or hematometra, which can cause significant pelvic pain. CASE PRESENTATION A 39-year-old woman with chief complaints of severe dysmenorrhea for five years. Despite receiving hormone therapy, the patient's symptoms persisted. She has only one living child born at laparotomy for an abdominal pregnancy 19 years ago. Upon ultrasound inspection, a 2.8 × 3 cm endometrioma was the only finding. Prior to her laparoscopic procedure, the woman had a unicornuate uterus on her right side with a normal cervix, and also a non-communicating hemiuterus in her left horn that had burst due to adhesion separation and was leaking chocolate fluid. On the left side, there was also a 3 × 3 cm endometrioma. Following that, a laparoscopic hysterectomy was carried out. DISCUSSION Although misread occasionally, the correct diagnosis of a unicornuate uterus with a noncommunicating horn is clinically important. The history of this patient's abdominal pregnancy may have developed in the rudimentary horn after sperm or fertilized eggs moved trans peritoneally, with life-threatening consequences if ruptured. This patient developed severe dysmenorrhea after receiving hormonal therapy, possibly caused by a noncommunicating left horn uterine hematometra and endometrioma. In this case, a laparoscopic hysterectomy was afterward chosen due to the patient's request according to her symptoms. CONCLUSION Unicornuate uterine with non-communicating horns is scarce however may cause severe complications. Considered a treatment to prevent related morbidity, laparoscopy is necessary to affirm the diagnosis.
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Affiliation(s)
- Arinil Haque
- Residence, Department of Obstetric and gynecologic, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital Surabaya, Indonesia.
| | - Jimmy Yanuar Annas
- Fertility Divison Staff, Obstetric and gynecologic Airlangga, Indonesia.
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Cruciat G, Staicu A, Florian A, Nemeti G, Sachelaru D, Andras D, Muresan D. Spontaneous Fistula and Abdominal Wall Endometriosis Due to Occult Existence of Unicornuate Right Uterus with Rudimentary Non-Communicating Functioning Left Horn. Diagnostics (Basel) 2024; 14:532. [PMID: 38473005 DOI: 10.3390/diagnostics14050532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
Accurate diagnosis of Müllerian duct anomalies (MDA) remains a clinical challenge even by direct surgical inspection. Although obstetrical complications are more frequent in women with MDA, some subtypes allow normal reproduction, further delaying the diagnosis. Unicornuate uterus with a rudimentary non-communicating functioning horn is a rare form of MDA, susceptible to many gynecologic and obstetric complications such as miscarriages, premature birth, hematosalpinx, endometriosis, and chronic pelvic pain. We present an entire case pictorial assay including preoperative imaging as well as the surgical correction of the uterine anomaly and the associated complication of an occult unicornuate right uterus with rudimentary non-communicating functioning left horn (Class U4aC0V0/ European Society of Human Reproduction and Embryology/European Society of Gastrointestinal Endoscopy Classification) and its natural evolution following a previous incomplete surgical treatment. The patient had an emergency left adnexectomy for hematosalpinx and ovarian endometrioma at her local county hospital. After five years, the patient presented with severe dysmenorrhea and abdominal endometriosis due to blocked retrograde menstruation from a rudimentary, non-communicating functioning horn. Surgical treatment with the resection of the rudimentary uterine horn, together with the abdominal wall endometriosis lesions, was carried out with good outcomes.
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Affiliation(s)
- Gheorghe Cruciat
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Adelina Staicu
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andreea Florian
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Georgiana Nemeti
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Diana Sachelaru
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - David Andras
- Department of Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Daniel Muresan
- Obstetrics and Gynecology I, Mother and Child Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Ahmad H, Wood RJ, Avansino JR, Calkins CM, Dickie BH, Durham MM, Frischer J, Fuller M, Ralls M, Reeder RW, Rentea RM, Rollins MD, Saadai P, Oelschlager AMEA, Breech LL, Hewitt GD, Kluivers K, van Leeuwen KD, McCracken KA. Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?: A Pediatric Colorectal and Pelvic Learning Consortium Study. J Pediatr Surg 2023; 58:471-477. [PMID: 35879143 DOI: 10.1016/j.jpedsurg.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND VACTERL association is defined by the presence of 3 or more anomalies in any of the following systems: vertebral, anorectal, cardiac, trachea-esophageal, renal, or limb. This study hypothesized that the presence of VACTERL association would correlate with an increased risk of gynecologic anomalies in patients with anorectal malformation (ARM). METHODS This study is a cross-sectional, retrospective analysis from the prospectively collected, multicenter registry of the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). The 834 female patients with ARM who were enrolled in the registry by January 1, 2020 were included in this study. The relationship of VACTERL association with presence of a gynecologic anomaly was evaluated with Fisher's exact test. The relationship of each VACTERL system with presence of a gynecologic anomaly was assessed in patients with cloaca, rectovestibular fistulas and rectoperineal fistulas. P-values reported were based on a 2-sided alternative and considered significant when less than 0.05. RESULTS 834 patients with ARM underwent VACTERL screening and gynecologic evaluation with the three most common subtypes being cloaca (n = 215, 25.8%), rectovestibular fistula (n = 191, 22.9%) and rectoperineal fistula (n = 194, 23.3%). A total of 223 (26.7%) patients with ARM had gynecologic anomalies. VACTERL association was seen in 380 (45.6%) of patients with ARM. Gynecologic anomalies were present in 149 (39.1%) vs. 74 (16.3%) of subjects with vs. without VACTERL association (p < 0.001). VACTERL association did not significantly increase the risk of gynecologic anomaly in patients with cloaca and VACTERL (n = 88, 61.5%) vs. cloaca without VACTERL (n = 39, 54.2% p = 0.308). VACTERL association increased the risk of gynecologic anomalies in patients with rectoperineal fistulas (n = 7, 14.9% vs n = 9, 6.1% p = 0.014) and rectovestibular fistulas (n = 19, 31.1% vs. n = 13, 10.0% p<0.001). In patients with ARM who had a VACTERL association, when one of the associated anomalies was renal, there was an even higher risk of having an associated gynecologic anomaly (n = 138, 44.2% vs. n = 85, 16.3% p<0.001). CONCLUSIONS VACTERL association in patients with rectoperineal and rectovestibular fistulas correlates with an increased risk of gynecologic anomalies. The presence of VACTERL associated findings, especially renal, should prompt a thorough evaluation of the gynecologic system. LEVEL OF EVIDENCE III. Retrospective comparative study.
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Affiliation(s)
- Hira Ahmad
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 700 Children's Drive, FOB 6B, Columbus, OH 43205, United States; Seattle Children's Hospital, Seattle, WA, United States.
| | - Richard J Wood
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 700 Children's Drive, FOB 6B, Columbus, OH 43205, United States
| | | | - Casey M Calkins
- Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | | | - Megan M Durham
- Emory-CHOA Pediatric Institute, Atlanta, GA, United States
| | - Jason Frischer
- Cincinnati Children's Hospital, Cincinnati, OH, United States
| | | | - Matt Ralls
- University of Michigan, Ann Arbor, MI, United States
| | - Ron W Reeder
- University of Utah School of Medicine, Salt Lake City, UT, United States
| | | | - Michael D Rollins
- Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Payam Saadai
- University of California Davis, Davis, CA, United States
| | | | - Lesley L Breech
- Cincinnati Children's Hospital, Cincinnati, OH, United States
| | - Geri D Hewitt
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 700 Children's Drive, FOB 6B, Columbus, OH 43205, United States
| | - Kirsten Kluivers
- Radboud University Medical Centre Nijmegen, Nijmegen, the Netherlands
| | | | - Katherine A McCracken
- Department of Pediatric Colorectal and Pelvic Reconstructive Surgery, Nationwide Children's Hospital, 700 Children's Drive, FOB 6B, Columbus, OH 43205, United States
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Jaouadi H, Theron A, Norscini G, Avierinos JF, Zaffran S. Genetic and phenotypic continuum of HOXA genes: A case with double HOXA9/HOXA13 mutations. Mol Med Rep 2023; 27:59. [PMID: 36734258 PMCID: PMC9936258 DOI: 10.3892/mmr.2023.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/30/2022] [Indexed: 02/04/2023] Open
Abstract
The HOXA genes cluster plays a key role in embryologic development. Mutations in HOXA genes have been linked to different human phenotypes, including developmental delay, limb anomalies, and urogenital malformations. The present study reported a clinical and genetic investigation of a female patient with polymalformative syndrome including left arm agenesis, bicornuate uterus and bicuspid aortic valve. Using whole exome sequencing, two heterozygous missense variants were identified. Of these, one was a novel variant in the HOXA13 gene [p.(Tyr290Ser)] and the second a heterozygous variant in the HOXA9 gene [p.(Ala102Pro)]. To the best of our knowledge, this is the first association of HOXA9/HOXA13 point mutations linked to a syndromic case. In conclusion, the present study suggested that the phenotypic spectrum of vertebral anomalies, anal atresia, cardiac defects, tracheo‑esophageal fistula, renal anomalies and limb abnormalities/hand‑foot‑genital syndrome may be attributable to the combination of different HOXA variants, particularly in patients with a severe clinical presentation. The current report contributed as well to the molecular understanding of HOXA genes‑related phenotypes via the identification of novel variant and genes associations.
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Affiliation(s)
- Hager Jaouadi
- Marseille Medical Genetics, U1251, National Institute of Health and Medical Research (INSERM), School of Medicine, Aix Marseille University, 13005 Marseille, France
| | - Alexis Theron
- Marseille Medical Genetics, U1251, National Institute of Health and Medical Research (INSERM), School of Medicine, Aix Marseille University, 13005 Marseille, France,Department of Cardiac Surgery, La Timone Hospital, 13005 Marseille, France
| | - Giulia Norscini
- Department of Cardiology, Public Assistance-Hospitals of Marseille, La Timone Hospital, 13005 Marseille, France
| | - Jean-François Avierinos
- Marseille Medical Genetics, U1251, National Institute of Health and Medical Research (INSERM), School of Medicine, Aix Marseille University, 13005 Marseille, France,Department of Cardiology, Public Assistance-Hospitals of Marseille, La Timone Hospital, 13005 Marseille, France
| | - Stéphane Zaffran
- Marseille Medical Genetics, U1251, National Institute of Health and Medical Research (INSERM), School of Medicine, Aix Marseille University, 13005 Marseille, France,Correspondence to: Dr Stéphane Zaffran, Marseille Medical Genetics, U1251, National Institute of Health and Medical Research (INSERM), School of Medicine, Aix Marseille University, 27 Bd Jean Moulin, 13005 Marseille, France, E-mail:
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LePoidevin L, Dunn T, Arian SE, Kaskar K, Schutt A. In vitro fertilization outcomes in VACTERL association (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies and limb anomalies): report of 2 cases. F S Rep 2022; 3:280-284. [PMID: 36212569 PMCID: PMC9532890 DOI: 10.1016/j.xfre.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To report 2 cases of women with vertebral defects, anal atresia, cardiac defects, tracheaesophageal fistula, renal anomalies, and/or limb anomalies (VACTERL association) and the outcomes of their in vitro fertilization (IVF) cycles. Design A case report. We obtained informed consent from both the patients for this case report. Setting Outpatient clinic at an academic hospital. Patient(s) Patient 1 was a 23-year-old woman with scoliosis, tethered spinal cord, tracheaesophageal fistula, duodenal atresia, and a common cloaca at birth. Patient 2 was a 36-year-old woman with dextrocardia, congenital heart disease, scoliosis, and an imperforate anus at birth. Intervention(s) Both the patients underwent IVF. Main Outcome Measure(s) Oocyte yield, oocyte quality, and number of embryos. Result(s) Patient 1 underwent 1 IVF cycle, with 16 oocytes retrieved, of which 6 were mature. However, during intracytoplasmic sperm injection, the oocytes were noted to be extremely fragile and degenerated immediately after sperm injection. No oocyte was fertilized. Patient 2 underwent 3 IVF cycles, and 2 oocyte retrievals, with a total of 7 oocytes under cryopreservation. Conclusion(s) Both the patients’ cases presented challenges due to aberrations in pelvic anatomy and poor IVF outcomes. There is a paucity of data regarding fertility outcomes and, specifically, oocyte quality in patients with vertebral defects, anal atresia, cardiac defects, tracheaesophageal fistula, renal anomalies, and/or limb anomalies association. Their care requires a multidisciplinary assessment, an individualized approach, and continued investigation of their IVF and fertility outcomes.
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Affiliation(s)
- Lindsey LePoidevin
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
- Correspondence: Lindsey LePoidevin, M.D., Department of Obstetrics and Gynecology, Baylor College of Medicine, 1 Baylor Plaza, Houston, Texas 77030.
| | - Timothy Dunn
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas
| | - Sara E. Arian
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas
| | - Khalied Kaskar
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas
| | - Amy Schutt
- Department of Reproductive Endocrinology and Infertility, Baylor College of Medicine, Houston, Texas
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Alrawashdeh MM, Alkazaleh F. Successful Laparoscopic Management of Non-communicating Rudimentary Horn Pregnancy. Cureus 2022; 14:e27268. [PMID: 36039256 PMCID: PMC9403603 DOI: 10.7759/cureus.27268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Unicornuate uteri are a type of Mullerian duct anomaly and the majority present with rudimentary horns. Rudimentary horn pregnancies are extremely rare and have a high risk of rupture. A high index of suspicion is needed to diagnose them early and unfortunately, the majority of cases are undetected until the patient presents with a ruptured uterus. Early diagnosis and management will reduce morbidities and mortality for patients. We present a case of a 29 year old who had a routine ultrasound scan in the first trimester that raised an index of suspicion for a rudimentary horn pregnancy. An MRI scan was performed and supplemented the ultrasound findings. The patient underwent laparoscopic management, and the non-communicating rudimentary horn, the foetus, and the attached tube were excised. The patient had a smooth recovery and had no complications. Due to the rarity of rudimentary horn pregnancies, a high index of suspicion is needed for a diagnosis. Timely detection and intervention are crucial to prevent complications. Ultrasound scans and MRIs can aid in the diagnosis. Traditional management involved laparotomy, but with surgical advancements, laparoscopic surgery can be utilized as a less invasive alternative.
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136 Unicornuate uterus with a non-communicating functioning rudimentary horn: A case report. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Nagshabandi ZK, Isaac B, Begum I. Unicornuate Uterus with Rudimentary Horn as a Rare Etiology of Secondary Dysmenorrhea: A Case Report. DUBAI MEDICAL JOURNAL 2021. [DOI: 10.1159/000519872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Congenital uterine anomalies are an uncommon type of female genital malformations caused by abnormal development of müllerian ducts during embryogenesis. Patients with an obstructive uterine anomaly have a higher risk of developing gynecological and obstetric complications that may present at menarche or later in life. We present a case of severe dysmenorrhea in a young teenager 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 with rudimentary horn excision, which was successfully managed laparoscopically. This case emphasizes the importance of physicians being cognizant in identifying patients with uterine anomaly to provide appropriate treatment and prevent adverse reproductive outcomes.
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A Jalil RA, Alsada AI. Unicornuate uterus with a functional non-communicating horn in adolescent. BMJ Case Rep 2021; 14:e242874. [PMID: 34446512 PMCID: PMC8395356 DOI: 10.1136/bcr-2021-242874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/04/2022] Open
Abstract
Common causes of pelvic pain are primary dysmenorrhoea, Müllerian duct anomalies, outflow obstruction, leiomyoma, endometriosis and adenomyosis. Unicornuate uterus with a rudimentary horn is a rare congenital malformation of the female genital tract, asymptomatic because of lack of functional endometrium. This study presents a rare case of a non-communicating functional rudimentary horn. A 16-year-old unmarried Yemeni female adolescent with a history of irregular painful menstrual period visited Obstetrics and Gynaecology outpatient clinic. Pelvic ultrasound was conducted showing an asymmetrical uterine configuration with the non-communicating rudimentary horn on the right side. Laparoscopic excision of the horn was planned for the patient. Non-communicating rudimentary horn with functional endometrium should be considered as a differential diagnosis in the female adolescent with obstructive uterine symptoms. Early diagnosis is crucial. Using the laparoscopic approach, an expert surgeon prefers definitive management to excise the rudimentary horn.
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Affiliation(s)
| | - Abeer Isa Alsada
- Department of Obstetrics and Gynaecology, Bahrain Defence Force Hospital, Manama, Bahrain
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Dhanawat J, Pape J, Stuhlmann‐Laeisz C, Maass N, Freytag D, Gitas G, Alkatout I. Ectopic pregnancy in noncommunicating horn of unicornuate uterus: 3D-ultrasound and primary laparoscopic management. Clin Case Rep 2021; 9:e04261. [PMID: 34084520 PMCID: PMC8142796 DOI: 10.1002/ccr3.4261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/23/2021] [Indexed: 11/12/2022] Open
Abstract
Unicornuate uterus with pregnancy in the noncommunicating rudimentary horn is extremely rare. Diagnosis requires awareness, high suspicion index, 3D ultrasound, and MRI. If missed, it can be catastrophic. Treatment varies across literature. We present a case where detection was done by 3D ultrasound and primary laparoscopic surgery done for treatment.
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Affiliation(s)
- Juhi Dhanawat
- Department of Gynecology and ObstetricsUniversity Hospitals Schleswig‐HolsteinKielGermany
| | - Julian Pape
- Department of Gynecology and ObstetricsUniversity Hospitals Schleswig‐HolsteinKielGermany
| | | | - Nicolai Maass
- Department of Gynecology and ObstetricsUniversity Hospitals Schleswig‐HolsteinKielGermany
| | - Damaris Freytag
- Department of Gynecology and ObstetricsUniversity Hospitals Schleswig‐HolsteinKielGermany
| | - Georgios Gitas
- Department of Gynaecology and ObstetricsUniversity Hospitals Schleswing‐HolsteinLeubeckGermany
| | - Ibrahim Alkatout
- Department of Gynecology and ObstetricsUniversity Hospitals Schleswig‐HolsteinKielGermany
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Begum J, Maharana N, Behera SS, Ali M, Mohakud S. Laparoscopic Approach Towards Non-Communicating Functional Rudimentary Uterine Horn: A Report of Two Cases. Cureus 2020; 12:e11419. [PMID: 33312815 PMCID: PMC7727771 DOI: 10.7759/cureus.11419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A unicornuate uterus is a relatively rare Müllerian anomaly with an incidence of 2.5-13%. It may lead to various gynecological or obstetric complications, and diagnosis can often be confusing and delayed. It is associated with varying clinical presentations depending on the presence of functional endometrium, which requires immediate surgical resection on the diagnosis. We report two cases of the unicornuate uterus in young women who presented with severe progressive dysmenorrhoea. These cases highlight the challenges in diagnosing the condition by ultrasound, which was confirmed later by MRI. Both cases were managed by laparoscopic resection of the functional non-communicating uterine horn. On follow-up, both patients were found asymptomatic with normal menstrual cycles. In patients of young age who present with abdominal pain, adnexal masses of unknown origin, and severely painful periods, we should consider Müllerian duct anomalies as one of the differential diagnoses. Early and proper preoperative diagnosis of these cases is essential to prevent complications and to offer adequate treatment. Operative laparoscopy is an excellent alternative to laparotomy for their management, particularly in young unmarried girls.
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Affiliation(s)
- Jasmina Begum
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Nibedita Maharana
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Shashi Shankar Behera
- Obstetrics and Gynecology, The Advanced Medical Research Institute, Bhubaneswar, IND
| | - Manwar Ali
- Surgery, All India Institute of Medical Sciences, Bhubaneswar, IND
| | - Sudipta Mohakud
- Radiology, All India Institute of Medical Sciences, Bhubaneswar, IND
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