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Case Reports
. 2021;28(2):367-373.
doi: 10.15388/Amed.2021.28.2.2. Epub 2021 Jul 29.

Uterine Didelphys with Transverse Vaginal Septum - A Complex Rare Müllerian Anomaly

Dina Aisha Khan  1 , Nalini Sharma  2 , Anusmita Saha  3 , Rituparna Das  3 , Subrat Panda  3
Affiliations
Case Reports

Uterine Didelphys with Transverse Vaginal Septum - A Complex Rare Müllerian Anomaly

Dina Aisha Khan et al. Acta Med Litu. 2021.

Abstract
in English, Lithuanian

During the development of the female genital tract, any insult to the normal development process results in a set of intriguing abnormalities known as Müllerian duct abnormalities. The uterine didelphys is the second least common type of anomaly among these, which may commonly be associated with a longitudinal vaginal septum (lateral fusion defect). However uterine didelphys along with a transverse vaginal septum (lateral fusion plus resorption defect) is a very rare finding and to the best of our knowledge, thecase that we hereby report is the second one in literature. A 16-year-old unmarried girl presented with primary amenorrhoea and cyclical pain for 18months.On clinical examination and imaging, a case of uterine didelphys and transverse vaginal septum was found. Her urinary tract was normalon USG and MRI evaluation. Excision of the septum was done by abdomino-vaginal approach. The patient was discharged well. We conclude that a patient presenting with primary amenorrhea especially with cyclical dysmenorrhea with a transverse vaginal septum on examination should be thoroughly investigated for associated upper genital tract abnormalities as the treatment strategy and prognosis is largely dependent on the correct classification of the anomaly.

Santrauka. Sutrikus moters lyties organų įprastam vystymuisi, atsiranda intriguojančių anomalijų, vadinamų Miulerio latakų anomalijomis. Dviguba gimda yra antra pagal retumą tarp šių anomalijų ir jai dažniausiai būdinga išilginė makšties pertvara (šoninio sujungimo defektas). Mūsų žiniomis, dviguba gimda su skersine makšties pertvara (šoninio sujungimo ir įsiurbimo defektu) pasitaiko labai retai – tai tik antras atvejis, aprašytas literatūroje.Šešiolikos metų netekėjusi mergina kreipėsi dėl pirminės amenorėjos ir menstruacinių skausmų, trunkančių 18 mėnesių. Atlikus klinikinę apžiūrą ir panaudojus medicininę atvaizdavimo techniką, nustatyta dviguba gimda ir skersinė makšties pertvara. Ištyrus ultragarsu ir atlikus MRT, anomalijų šlapimtakiuose nenustatyta. Pertvara pašalinta atlikus pilvo ir makšties operaciją. Išrašoma pacientė jautėsi gerai.Darome išvadą, kad pacientė, kuriai buvo pirminė amenorėja, ypač jei yra dismenorėja ir apžiūros metu nustatoma skersinė makšties pertvara, turėtų būti nuodugniai ištirta dėl galimų viršutinių lyties organų anomalijų, nes teisingai nustačius anomaliją parenkamas tinkamas gydymas ir nustatoma teisinga prognozė.Raktažodžiai: Miulerio latakų anomalija, dviguba gimda, skersinė makšties pertvara, pirminė amenorėja, dismenorėja.

Keywords: Müllerian duct anomaly; dysmenorrhoea; primary amenorrhoea; transverse vaginal septum; uterine didelphys.

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Figures

Figure 1.
Figure 1.
T2 coronal showing twouteruses. Upper vaginal cavity is distended with hyperintense collection
Figure 2.
Figure 2.
T2 axial shows dilated endometrial cavity of uterus communicating with collection of upper vaginal cavity
Figure 3.
Figure 3.
Centrally placed – distended right uterus with normal size(bulky) left uterus
Figure 4.
Figure 4.
After excision of transverse vaginal septum
See this image and copyright information in PMC

References

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