{"paper_id":"0233d819-5ef3-4d25-8cd4-dc9c912090b7","body_text":"Abstract\nCongenital uterine anomalies with outflow tract obstruction caused by abnormal Mullerian duct system development are rare conditions that can lead to painful pelvic emergencies such as hematometra. A unicornuate uterus with a rudimentary horn occurs in about 2.4–13% of all Müllerian duct anomalies with a prevalence of 1 in 100000 fertile women. Clinical symptoms such as dysmenorrhea, dyspareunia, and acute and chronic pelvic pain usually develop at and after menarche. Accurate diagnosis and timely surgical intervention are crucial to prevent complications such as adenomyosis, endometriosis, and infertility. A 21-year-old nulligravida Afghan female presented with severe chronic pelvic pain that worsened during menstruation and coitus. Ultrasonography and magnetic resonance imaging (MRI) revealed two separate uterine bodies. The left body was a unicornuate uterus with an endometrial lining connected to the cervix and the vaginal canal. The right body showed a functioning non-communicating rudimentary horn containing hematometra without a cervical opening. The patient underwent a hemi-hysterectomy and the rudimentary horn was removed. The histopathological findings revealed adenomyosis with cystic changes. The patient recovered after the operation and her severe pain subsided. This case underscores the importance of timely diagnosis and management of rare non-communicating functioning rudimentary horn anomalies that occur in less than 0.06% of reproductive-age women. Notably, this report adds to the limited literature on this anomaly where the rudimentary horn contained extensive adenomyosis, highlighting the potential for significant histopathological changes in such anomalies. Precise diagnosis and surgical excision are critical to prevent complications.\nSimilar content being viewed by others\nData Availability\nThe data generated and analyzed during this study are not openly available to protect the patient’s privacy and are available from the corresponding author upon reasonable request.\nCode Availability\nNot applicable.\nAbbreviations\n- MDA :\n-\nMullerian duct anomaly\n- MRI :\n-\nMagnetic resonance imaging\n- HSG :\n-\nHysterosalpingography\n- USG :\n-\nUltrasonography\n- ESHRE :\n-\nEuropean Society of Human Reproduction and Embryology\n- ESGE :\n-\nEuropean Society for Gynaecological Endoscopy\n- AFS :\n-\nAmerican Fertility Society\nReferences\nBodur S, Fidan U, Kinci MF, Karasahin KE. Unicornuate uterus with a rudimentary horn diagnosed at scheduled third Cesarean Section. Pak J Med Sci. 2017;33:779–81.\nLadke P, Ambhore AN, Dhok A, Mitra K, Dalvi V. A unique case of unicornuate uterus with a non-communicating rudimentary horn and hematometra. 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J Obstet Gynaecol Res. 2006;32:74–9.\nAcknowledgements\nThe authors would like to express their utmost gratitude to the patient and her family for their informed permission and consent to report this case.\nAuthor information\nAuthors and Affiliations\nContributions\nFWJ performed the diagnosis, clinical follow-up, and therapeutic management. FWJ and AMJ designed and drafted the manuscript, added critical revisions for intellectual content, and generated the figures. RJ, HA, and KS assisted with the clinical management and data collection. RS provided pathology analysis. All authors have read and approved the final manuscript.\nCorresponding authors\nEthics declarations\nEthics Approval\nThis study was reviewed by the FMIC Ethical Review Committee (076-FMIC-ER-23), which determined that ethical approval was not required due to the nature of the study and patient data. A copy of the exemption letter is available upon request from the corresponding author.\nConsent to Participate\nWritten informed consent was obtained from the patient and her family for the surgical procedure, the use of data for publication, and any other necessary interventions. A copy of the written consent is available upon request from the corresponding author.\nConsent for Publication\nWritten informed consent was obtained from the patient and her family for the use of data for publication. A copy of the written consent is available upon request from the corresponding author.\nCompeting Interests\nThe authors declare no competing interests.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nThis article is part of the Topical Collection on Surgery\nSupplementary Information\nBelow is the link to the electronic supplementary material.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nWali Jebran, F., Jebran, A.M., Jalalzai, R. et al. Adenomyosis and Hematometra in a Non-communicating Rudimentary Horn of a Unicornuate Uterus: A Case Report. SN Compr. Clin. Med. 7, 57 (2025). https://doi.org/10.1007/s42399-025-01798-3\nReceived:\nRevised:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s42399-025-01798-3","source_license":"CC0","license_restricted":false}