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Uterus didelphys

Case contributed by Nick Tarasov
Diagnosis almost certain

Presentation

Presents post cesarean section with known history of anomaly for scar evaluation.

Patient Data

Age: 30 years
Gender: Female
mri

There is uterus didelphys: two independent uterus bodies, cervix, and vaginal vertical septum, well seen on coronal T2 images. Both uteri demonstrate normal zonal anatomy.

There are many follicles in the right ovarian, less on the left. 

Gartner duct cysts are located in the anterolateral wall of the proximal portion of the vagina at the level of the pubic symphysis, showing a hypersignal on both T1 and T2 images. 

Well-defined on T2 images scar post-cesarean section, located at the right uterus, measuring 13 x 8 x 8 mm, it seems healthy. 

There is no free fluid, lymphadenopathy. Surrounding visible bones, soft tissues, vessels, rectum, and bladder are unremarkable. No diffusion restriction.

 

Case Discussion

This is a nice case of class III Müllerian duct anomaly: uterus didelphys, also, with happy end of pregnancy with cesarean section and birth a healthy child. 

Müllerian duct anomalies (MDAs) are congenital anatomic abnormalities of the female genital tract that arise from nondevelopment or nonfusion of the müllerian ducts or failed resorption of the uterine septum, with a reported incidence of 0.5%–5.0%. MDAs are clinically important because they are associated with an increased incidence of impaired fertility, menstrual disorders, and obstetric complications. MDAs are also associated with an increased incidence of endometriosis and obstructed uterine drainage, which may occur in patients with unicornuate uterus or uterus didelphys (which is reported to occur in 0.1–0.5% of women).

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