Rudimentary uterine horn: Management of a diagnostic enigma

The aim of this study was to review the presentation, diagnosis, investigations, management, and outcome in women with a unicornuate uterus and a noncommunicating rudimentary horn. The study group consisted of three women diagnosed between the 1998 and 2000 as having a noncommunicating rudimentary uterine horn. This retrospective study investigated the diagnostic tools and complications in these women. All the women had a detailed menstrual history, a pelvic examination by a senior gynecologist, and an ultrasound scan. Table I outlines the clinical symptoms and investigations undertaken. I Correlation of symptoms, clinical findings and investigationsSymptomsCase Age Abdominal pain Dysmenorrhoea Exam findings Pelvic USS MRI scan Laparoscopy Hysteroscopy IVU Treatment no.1 21 Chronic abdominal and pelvic, many hospital admissions Yes Mass felt in left adenexa Mass 5×3x1 cm Near uterus on left Non‐communicating rudimentary horn on left Rounded rudimentary horn attached to uterus on left, Main uterus on right – NAD Laparotomy: thick chocolate material, horn excised, cavity closed in two layers 2 18 Acute lower abdominal pain Laparotomy‐ Yes NAD Uterus deviated to right. Mass 3×4 cm on left near uterus – Main uterus on right, unicornuate horn with fibrous band on left Left ostium not seen NAD Laparoscopy: as above 3 23 Yes, PV bleeding, and positive urine pregnancy test – Tenderness and swelling left adenexa 9‐week viable pregnancy in left adenexa ectopic pregnancy – Right unicornuate uterus with normal tube and ovary Pregnant left rudimentary horn – NAD Laparoscopy excision of rudimentary horn wit products of conceptionh pregnant uterine horn