Hematometra in a bicornuate uterus

Case contributed by Dr Rodney Strahan


Recurrent pelvic pain associated with periods.

Patient Data

Age: 16
Gender: Female

Ultrasound at time of pain

Large thick walled fluid filled cavity with fluid/fluid levels in the left side of the pelvis. Soft tissue mass on the right side of the pelvis with possible endometrial stripe.

Ovaries superior to masses and normal with follicles present.


Ultrasound 2 weeks after initial study

2 weeks after the initial ultrasound, the right sided mass is a uterus with a thick endometrial echo.

The left sided mass has changed its internal echogenicity.



HSG: Single vagina and cervix identified on examination. Contrast in right side of uterus with single fallopian tube and peritoneal spillage.

Case Discussion

The patient presented with recurrent pelvic pain associated with her periods. At the time of her period and pain, on the first ultrasound, the endometrial stripe in the right uterine cornu was difficult to appreciate. A repeat ultrasound midcycle confirmed a thickened endometrial echo on the right and changed echogenicity of the left fluid collection. Aspiration of the left sided fluid collection confirmed blood.

EUA could not identify an opening for the obstructed left sided cornu, with only one vagina present.

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Case information

rID: 50817
Published: 23rd Jan 2017
Last edited: 14th Aug 2019
System: Gynaecology
Inclusion in quiz mode: Included

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