Yadav Siddhartha Kumar, Yadav Indra, Jyoti Sabita, Lama Prasanna, Yadav Rozy
Birat Medical College Teaching Hospital, Tankisinuwari, Biratnagar, Nepal.
Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal.
JNMA J Nepal Med Assoc. 2024 May 31;62(274):404-406. doi: 10.31729/jnma.8617.
Developmental anomalies of genital tract result from defective fusion and absorption of various parts of Mullerian ducts in fetal life. Rudimentary horn pregnancy (RHP) is a rare occurrence of one in 76,000 and one in 160,000. We present a case of a 24-year-old primigravida with ruptured RHP initially managed in the line of an intrauterine pregnancy with severe anemia. Hemodynamic instability made us suspect ruptured RHP and lifesaving laparotomy was performed for the same. A 1.5-liter hemoperitoneum was encountered with a right RHP. Multiple adhesions were present with necrotic tissue adherent and clumped together as tubo-ovarian mass. Resection of rudimentary horn was performed. We report this case to emphasize the need to consider rare uterine anomalies as a possibility in patients presenting with acute abdomen in early pregnancy. So, Obstetricians can consider these rare entities in differential diagnosis and management.
生殖道发育异常是由于胎儿期苗勒管各部分融合和吸收缺陷所致。残角子宫妊娠（RHP）极为罕见，发生率约为1/76000至1/16000。我们报告一例24岁初孕妇，其残角子宫妊娠破裂，最初按照宫内妊娠处理，伴有严重贫血。血流动力学不稳定使我们怀疑为残角子宫妊娠破裂，遂进行了挽救生命的剖腹手术。术中发现右侧残角子宫妊娠破裂，腹腔积血1.5升。存在多处粘连，坏死组织粘连并聚集成输卵管卵巢肿块。行残角子宫切除术。我们报告此病例以强调，对于早期妊娠出现急腹症的患者，需要考虑罕见子宫异常的可能性。因此，产科医生在鉴别诊断和处理时可考虑这些罕见情况。
