Case 94: Uterus Didelphys with Obstructing Hemivaginal Septum and Ipsilateral Renal Agenesis

Abstract

History A 12-year-old girl was admitted to the hospital because of lower abdominal pain. She reproted previous episodes of similar, but less severe, pain. Physical examination did not reveal any abnormal findings, and there was only mild tenderness at palpation of the middle lower abdomen. Findings of laboratory test were unremarkable, with a total white blood cell count of 7.16 × 10 9 /L (normal range, [5.5-11.5] × 10 9 /L), a differential cell count of 64.8% neutrophils (normal range, 40.9%-64.9%), and a hemoglobin level of 14.2 g/dL (normal range, 14.0-16.0 g/dL). The patient's medical history was noncontributory. Menstruation first occurred in this patient at 11 years of age; at admission, she was on the 3rd day of her menstrual cycle. The patient underwent ultrasonography (images not shown). Magnetic resonance (MR) imaging of the pelvis was recommended and performed to enable further evaluation.