Sarikaya Sevcan, Aybay Muhsin Nuh
Department of Obstetrics and Gynecology, Mardin State Hospital, Mardin, Turkey.
Department of Radiology, Private Doruk Yildirim Hospital, Bursa, Turkey.
Int J Surg Case Rep. 2022 May;94:107003. doi: 10.1016/j.ijscr.2022.107003. Epub 2022 Mar 29.
Pregnancy of Rudimentary Horn is a type of ectopic pregnancy, that is recognized almost always during surgical treatment of a rupture of the rudimentary horn. This is an obstetric case diagnosed preoperatively by magnetic resonance imaging (MRI).
We report the case of a 19-years-old primigravida patient with rupture of rudimentary horn in 26th gestational week. The patient presented with sudden onset severe abdominal pain in the emergency room. Intraabdominal free fluid is detected. To evaluate the etiology of free fluid and location of the gestational sac, an abdominal magnetic resonance imaging (MRI) scan was planned. The decision of emergent laparotomy is made because of sonographic detection of abdominal excessive -concentrated- free fluid, abdominal tenderness, and 2 points decrease of hemoglobin value in the control hemogram. A rudimentary horn pregnancy and fundal rupture of the rudimentary part of the uterus are diagnosed during the surgical procedure. A baby -live- weighing 450 g was delivered. The ruptured rudimentary horn and same-sided tuba uterina were surgically removed.
Rudimentary horn pregnancy is a rare ectopic pregnancy. Diagnosis is difficult clinically, even with diagnostic imaging modalities. Identifying both cornuas systematically in all patients increases the detection rate. The absence of continuity between the gestational sac's lumen and the cervical canal on imaging is an important finding.
Due to the serious maternal and fetal complications, its detection at an early week may be life-saving.
残角子宫妊娠是一种异位妊娠，几乎总是在残角子宫破裂的手术治疗过程中才被发现。这是一例术前通过磁共振成像（MRI）诊断的产科病例。
我们报告一例19岁初产妇，在妊娠第26周时发生残角子宫破裂。患者在急诊室突然出现剧烈腹痛。检测到腹腔内有游离液体。为评估游离液体的病因及妊娠囊的位置，计划进行腹部磁共振成像（MRI）扫描。由于超声检查发现腹腔内有过多高浓缩游离液体、腹部压痛以及血常规检查中血红蛋白值下降2个点，决定进行急诊剖腹手术。手术过程中诊断为残角子宫妊娠及子宫残角底部破裂。娩出一名体重450克的活婴。手术切除破裂的残角子宫及同侧输卵管。
残角子宫妊娠是一种罕见的异位妊娠。即使使用诊断性影像学检查方法，临床上诊断也很困难。对所有患者系统性地识别双侧子宫角可提高检出率。影像学检查显示妊娠囊腔与宫颈管之间无连续性是一项重要发现。
由于存在严重的母婴并发症，早期发现可能挽救生命。
