Postmenopausal bleeding with a diadelphic uterus: A case report

Abstract

: Simple uterine anomalies to more complicated multisystem derangements can all fall under the broad category of congenital abnormalities known as mullerian duct anomalies. Urological and caudal gastrointestinal abnormalities may be linked to complete uterine, cervix, and vaginal duplication.: This case report aims to raise awareness of the challenges surgeons face while treating Mullerian abnormalities and to foresee ureter and artery supply duplication.: In this case report, 59 year old, P1L1, Previous LSCS with diadelphic uterus with longitudinal vaginal septum presented with postmenopausal bleeding. MRI of the patient showed endometrial hyperplasia in both uteri with no obvious myometrial infiltration. Patient was planned for hysterectomy frozen section and proceed SOS to staging laparotomy in view of recurrent postmenopausal bleeding and morbid obesity. Total abdominal hysterectomy with bilateral salphingophorectomy with frozen section done. During surgery bladder was adherent to previous c section scar on the left horn, left sub total hysterectomy was done and sent for frozen followed by right total hysterectomy. Along with the right total hysterectomy sample both cervices were delivered. Frozen section showed a simple hyperplasia without atypia in left horn and hyperplasia with foci of intraepithelial neoplasia in right horn, Final histopathology further confirmed the same report. : It's important to have a full awareness of any potential related deformities when managing patients with Mullerian defects and irregular uterine haemorrhage. To prevent urological problems and surgical mishaps, a thorough preoperative evaluation, meticulous surgical investigation, and multidisciplinary approach may be required.