PMC5402867_01
A 13-year-old girl with pelvic pain and bad-smelling, green-coloured vaginal discharge, case I. On axial sonography at the level of the vaginas, (A) more to the left side (star), both hemivaginas are dilated and have fluid echoes. Axial T2W images at the level of uterus (B) and vaginas (C) show uterus didelphis and dilated right (arrow) and left (star) hemivaginas with slightly hypointense fluid contents consistent with haematocolpos. Note the tubular cystic structure in the wall of the left hemivagina (arrowhead).
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The left hemivagina was distended with fluid content, and there was also fluid in the right hemivagina with similar properties (Figure 1A). MR imaging was performed to study the abnormalities in detail. MR imaging confirmed two separate uteri with two separate cervices (uterus didelphys bicollis) and two proximal vaginas (Figure 1B). T1-weighted images and a slightly hypointense fluid on T2-weighted images, suggesting a blood collection (haematocolpos). There was also a tubular structure inside the lateral wall of the left hemivagina that could be an urethral remnant (Figure 1C).
PMC5402867_02
A 15-year-old girl with dysmenorrhea, case II. On a sagittal view, the right kidney (A) was absent and the left kidney (B) was hypertrophic. Axial sonography image (C) demonstrates dilated left hemivagina with echogenic content (arrowhead) and normal right hemivagina (arrow). Axial T2W images at the level of uterus (D) and vaginas (E) show uterus didelphis and dilated left hemivagina with slightly hypointense fluid consistent with haematocolpos (star) and normal right hemivagina (arrow).
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She was referred to the radiology department for pelvic ultrasonography, which showed uterus didelphis and left-sided dilated hemivagina with echogenic content (Figure 2A). The right kidney was absent and the left kidney was hypertrophic (Figure 2B, 2C). T1- and T2-hyperintense fluid consistent with haemorrhage was depicted (Figure 2D, 2E). The right hemivagina was normal in shape.