PMC6796699_01
CT demonstrating absent left kidney, uterine duplication, suggestive of cervical duplication, and distension of the left cavity by hypodense material.
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In addition to the ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) were performed (Fig. 1, Fig. 2, Fig. 3), both demonstrating uterus didelphys, left renal agenesis, and the presence of two endometrial cavities: a right-sided cavity with a thickness of 3.8 mm and a left-sided cavity filled with a hypodense material, likely demonstrative of blood.
Pelvic MRI, transverse T2-weighted image, depicting a duplicated uterus and the presence of two endometrial cavities: right-sided cavity with 3.8 mm thickness and distended left cavity filled with hyperintense material.
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In addition to the ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) were performed (Fig. 1, Fig. 2, Fig. 3), both demonstrating uterus didelphys, left renal agenesis, and the presence of two endometrial cavities: a right-sided cavity with a thickness of 3.8 mm and a left-sided cavity filled with a hypodense material, likely demonstrative of blood.
Images obtained via hysteroscopy. A) Single and normal cervix on the right. B) Absence of bulging on the left lateral wall of the vagina (dashed line) or its recess. C) Ostium of the right uterine tube (dashed circle), without alterations. D) Absence of ostium of the left uterine tube.
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Hysteroscopic examination revealed a right-sided patent hemiuterus with a single uterine cervix, uterine tube, and ostium and a left-sided atretic hemiuterus without any lateral vaginal wall bulging or associated left uterine tube ostium (Fig. 4).
Laparoscopic hysteroscopy. Visualization of the larger left hemiuterus (left side of image) and right hemiuterus of smaller volume. Note the myometrial bridge connecting the two structures.
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Uterus bicornis was identified, and the left hemiuterus was distended and connected to the right one only by a myometrial strand (Fig. 5).
Left hemiuterus and uterine tube after laparoscopic resection.
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A left salpingectomy was performed with preservation of the left ovary, followed by left hemi-hysterectomy, ligation of the left uterine vessels, and resection of the myometrial segment connecting the two hemiuteri at a level adjacent to the cervix of the right hemiuterus (Fig. 6).