Answer for BIR CoW 26 Mar 2023
Unicornuate uterus
Findings
HSG shows banana shaped uterus deviated to right with solitary fallopian tube. Peritoneal contrast spillage noted in right solitary tube - F/s/o Unicornuate uterus (class II mullerian anomaly). MRI shows unicornuate uterus with no obstructed rudimentary horn and bilateral polycystic appearing ovaries.
Discussion
Unicornuate uterus results from normal development of one mullerian duct and abnormal development (hypo- or aplasia) of the other mullerian duct Unicornuate uterus may be of 4 types: 1. Simple unicornuate 2. Unicornuate with a non-communicating non- cavitating rudimentary horn, 3. Unicornuate with a non-communicating cavitating rudimentary horn, 4. Unicornuate with a communicating rudimentary horn Patients with a unicornuate uterus and obstruction at the level of the cervix or the vagina tend to present with either hydrometra or hydrometrocolpos as neonates or at menarche. The presence of a cavitary, non- communicating horn may be masked by release of menstrual products via retrograde flow through a patent fallopian tube. Patients with a partially obstructed, aplastic, or incomplete fallopian tube may present at puberty with pain caused by distention of the uterine horn . The simple unicornuate uterus and the cavitary, communicating rudimentary horn variety are generally discovered incidentally in the adult during an infertility workup or during examination of other pelvic pathology.
Findings
HSG shows banana shaped uterus deviated to right with solitary fallopian tube. Peritoneal contrast spillage noted in right solitary tube - F/s/o Unicornuate uterus (class II mullerian anomaly). MRI shows unicornuate uterus with no obstructed rudimentary horn and bilateral polycystic appearing ovaries.
Discussion
Unicornuate uterus results from normal development of one mullerian duct and abnormal development (hypo- or aplasia) of the other mullerian duct Unicornuate uterus may be of 4 types: 1. Simple unicornuate 2. Unicornuate with a non-communicating non- cavitating rudimentary horn, 3. Unicornuate with a non-communicating cavitating rudimentary horn, 4. Unicornuate with a communicating rudimentary horn Patients with a unicornuate uterus and obstruction at the level of the cervix or the vagina tend to present with either hydrometra or hydrometrocolpos as neonates or at menarche. The presence of a cavitary, non- communicating horn may be masked by release of menstrual products via retrograde flow through a patent fallopian tube. Patients with a partially obstructed, aplastic, or incomplete fallopian tube may present at puberty with pain caused by distention of the uterine horn . The simple unicornuate uterus and the cavitary, communicating rudimentary horn variety are generally discovered incidentally in the adult during an infertility workup or during examination of other pelvic pathology.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!