Bicornuate uterus

Case contributed by Manar Alaa El Din osman
Diagnosis almost certain

Presentation

Irregular menstrual bleeding.

Patient Data

Age: 15 years
Gender: Female
mri

Two endometrial cavities are seen at the level of the uterine fundus with fundal cleft (about 1.3 cm in depth), two cervical canals and a single vagina.

Bilateral bulky ovaries with peripheral arrangement of follicles.

Case Discussion

Bicornuate uterus is classified as a class IV Mullerian duct anomaly. It's characterized by fundal clefting that may extend to the cervical canal (Bicornuate Bicollis) or the level of the internal os with one cervix (Bicornuate Unicollis).

Differential diagnoses include a septate uterus in which there is no external clefting but show a flat uterine fundus with an internal septum and uterine Didelphis in which there is a complete failure of Mullerian fusion.

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