Laparoscopic management of unicornuate uterus with non-communicating rudimentary horn and ipsilateral ovarian endometrioma with dense adhesion: a case report

Abstract

A unicornuate uterus with a non-communicating rudimentary horn is a rare Mullerian anomaly that has been associated with various comorbidities including hematometra, endometriosis and obstetric complications. Laparoscopy has proven to be an effective and minimally invasive surgical approach to the management of uterine anomalies. We present the case of a 23-year-old nulligravida woman with dysmenorrhea and vaginal spotting. Hysterosalpingogram and magnetic resonance imaging revealed a right unicornuate uterus, left rudimentary horn and ipsilateral ovarian endometrioma. In addition, computed tomography (CT) demonstrated absence of the left kidney and ureter. The course of the patient's uterine artery was examined with CT angiography. At laparoscopy the rudimentary horn was not identified initially because of the large endometrioma and dense adhesion. After adehesiolysis, laparoscopic removal of the rudimentary horn and ipsilateral salpingo-oophorectomy was performed without complications. The CT angiography was useful for the safe performance of laparoscopic management of this case.