Suryawanshi Shweta V, Dwidmuthe Kanchan S
Department of Obstetrics and Gynaecology, Narendra Kumar Prasadrao (NKP) Salve Institute of Medical Sciences and Research Centre, Nagpur, IND.
Cureus. 2023 Apr 21;15(4):e37959. doi: 10.7759/cureus.37959. eCollection 2023 Apr.
Congenital uterine anomalies (CUAs) or Müllerian duct anomalies are rare and can be either complete failure or partial failure in the development of the Mullerian duct, and they have a probability to result in a condition known as the unicornuate uterus. Partial development of one of the horns results in a rudimentary horn, which may be communicating consisting of category II A or noncommunicating consisting of category II B. This report illustrates a rare case of a 23-year-old female, unmarried, nulligravida, who presented to the outpatient department with chief complaints of acute abdominal pain and dysmenorrhea associated with an average menstrual flow. Pelvic ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of a left unicornuate uterus with communicating right rudimentary horn associated with hematometra and hematosalpinx. As a treatment option, the surgical intervention mainly involved laparoscopic excision of the rudimentary horn and right salpingectomy that was performed by aspiration of blood from the rudimentary horn of around 25cc. Then, the right hydrosalpinx was removed, followed by right salpingectomy and excision of the rudimentary horn to reduce the risk of ectopic pregnancy having an incidence of 10% for which laparoscopic or robotic-assisted removal is preferable and practicable for young girls, compared with the open procedure. The patient adhered well to the surgical intervention.
先天性子宫异常(CUAs)或苗勒管异常较为罕见,可能是苗勒管发育完全失败或部分失败,且有可能导致单角子宫这种情况。其中一个角部分发育会形成残角,残角可能是连通的(II A类)或不连通的(II B类)。本报告阐述了一例罕见病例,患者为一名23岁未婚未孕女性,因急性腹痛和痛经伴月经量正常为主诉前来门诊就诊。盆腔超声和磁共振成像(MRI)确诊为左侧单角子宫伴右侧连通性残角,合并积血和输卵管积血。作为治疗选择,手术干预主要包括腹腔镜下切除残角和右侧输卵管切除术,通过从约25cc的残角中抽吸血液来进行。然后,切除右侧输卵管积水,接着进行右侧输卵管切除术和残角切除术,以降低异位妊娠风险,异位妊娠发生率为10%,与开放手术相比,腹腔镜或机器人辅助切除对年轻女孩更可取且可行。患者对手术干预依从性良好。