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Bicornuate uterus

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Primary infertility.

Patient Data

Age: 25 years
Gender: Female

Pelvis

mri

Duplication of the uterine body, cervix and upper two-thirds vagina.

Heart-shaped external contour of the uterus with fundal indentation > 50% of the uterine wall thickness with intercornual distance > 4 cm and angle > 60 degrees reflecting bicorporeal septate uterine body and one external contoured cervix.

Completely separate endometrial and endo-cervical cavities with preserved surrounding zonal anatomy reflecting complete septate cervix.

The duplicated upper two-thirds vagina with intervening linear fat intensity interface reflecting longitudinal septum. None of the hemi-vaginas revealed ballooning showing preserved zonal anatomy reflecting direct communication with the external introitus reflecting non-obstructing septum type.

RVF uterine axis, still with average uterine body to cervix ratio for age. No myometrial or endometrial lesions identified.

Mild diffuse pelvic varices.

Case Discussion

Overall features of bicorporeal complete septate uterus and cervix (muscular type) with longitudinal non-obstructing vaginal septum - mullerian duct anomaly ESHRE U3c C1 V1.

 

Case courtesy Dr Heba Hassan, Professor of Radiology, Alexandria university, Egypt.

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