Uterus didelphys with longitudinal vaginal septum

Case contributed by Michael Burns



Patient Data

Age: 12 years
Gender: Female

Examination of the pelvis shows a bifid uterus with no focal abnormality of either endometrial cavity seen. 
The adnexae are unremarkable with no masses or abnormal fluid collections seen.
Small amount of free fluid is seen in the cul-de-sac, within normal limits for age.

Duplication of the endometrial cavity as seen on ultrasound. The lower uterine segments diverge laterally away from each other, and there is duplication of the cervices. There is also duplication of the vagina, forming 2 separate cavities which unite above the level of the introitus. No evidence of a transverse vaginal septum, or of hematometrocolpos. There is fluid within the endometrial cavities bilaterally, likely physiological blood. No focal uterine lesion. Both ovaries are normal in appearance, containing small physiological follicles. No adnexal masses. Small volume of pelvic free fluid, likely physiological. No pelvic lymphadenopathy. No destructive bony lesion. 

Uterus didelphys and incomplete longitudinal vaginal septum. No obstruction is seen.

Case Discussion

MRI provides excellent delineation of congenital uterine anomalies.

The kidneys should also be checked on ultrasound or MRI as uterus didelphys can be associated with unilateral renal agenesis.

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