Longitudinal vaginal septum

Last revised by Joshua Yap on 1 Sep 2022

A longitudinal vaginal septum is a congenital abnormality of the vagina where it is divided into two parallel cavities by a septum.

It is usually asymptomatic unless obstructed, in which case it may cause cyclic pelvic pain. Amenorrhea may occur if both cavities are obstructed 1.

A longitudinal vaginal septum typically arises with other Müllerian duct anomalies such as a septate uterus or uterus didelphys 2. However, it can also arise as an isolated anomaly 3

It is due to failure of lateral fusion/reabsorption of the paired Müllerian ducts during development of the vagina.

It may be difficult to diagnose in the absence of obstruction.

T2-weighted images demonstrate a hypointense septum (relative to the hyperintense secretions/blood) with two hemivaginas present 1,3

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