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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 11

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Ginecol Obstet Mex 2020; 88 (11)

Diagnosis and management of hematosalpinx and hematometra in a patient with a hemiuterus and rudimentary uterine hemicavity noncommunicating. Case report and review of literature

Navarro-Sierra J, Gabasa-Gorgas L, Giménez-Molina C, Espiau-Romera A, Yagüe-Moreno H, Bolea-Tobajas R

Language: Spanish
References: 32
Page: 820-827
PDF size: 457.08 Kb.


ABSTRACT

Background: Congenital malformations of the female genital tract have an overall prevalence of approximately 3% and the origin is due to an alteration in the embryological development of the Müllerian ducts. The hemi-uterus with a rudimentary cavity has a prevalence of only 0.1%
Case Report: 29-year-old patient was admitted to emergency department with a 3-month severe dysmenorrhea associated with irregular menstrual cycles, without reporting improvement with oral analgesia and oral contraceptive. She had no medicalsurgical history of interest or previous sexual relations. During the study using 2D ultrasound and pelvic computed tomography, a congenital uterine malformation was observed, corresponding to a hemi-uterus with a rudimentary non-communicating cavity and a retention content compatible with a 55x48mm hematometra and another elongated and angled cystic structure with 65x21mm echogenic content suggestive of hematosalpinx. Treatment with GnRH analogues was prescribed until surgery was performed. Finally, laparoscopic excision of the rudimentary cavity and the ipsilateral left tube was performed. The postoperative evolution was satisfactory. Currentlythe patient is asymptomatic.
Conclusions: In the study of uterine malformations, the pertinent imaging tests must be included in order to establish correct surgical management. When a hemi-uterus with a rudimentary cavity is diagnosed, a laparoscopy should always be performed to remove both the rudimentary cavity and the ipsilateral uterine tube to avoid short and long-term obstetric-gynecological complications.


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