A rare case of unicornuate uterus with non-communicating functional rudimentary horn associated with grade 3 endometriosis and a vascular anomaly

A rare case of unicornuate uterus with non-communicating functional rudimentary horn associated with grade 3 endometriosis and a vascular anomaly DOI: https://doi.org/10.18203/2320-1770.ijrcog20260568Keywords: Unicornuate uterus, Endometriosis, Rudimentary horn, Müllerian duct anomaliesAbstract Uterine anomalies result from either non-fusion or aberration in the fusion of the Müllerian ducts. An unicornuate uterus is one such anomaly that can present in different age groups due to its variation in relation to the presence or absence of a rudimentary horn. It can present as severe dysmenorrhea in young women if there is hematometra in the non-communicating functional rudimentary horn or if there is associated endometriosis. It can also present with infertility, recurrent pregnancy loss, or preterm delivery, and can be incidentally diagnosed during a cesarean section. One of the dreaded complications is pregnancy in the non-communicating horn and its rupture. It can pose a diagnostic and management challenge. Magnetic resonance imaging (MRI) is the gold standard for diagnosis, and surgical management is imperative in case of a functional non-communicating horn for relief of dysmenorrhea, prevention of endometriosis, and to prevent pregnancy complications. We report a case of a woman in her early 20s with severe dysmenorrhea and infertility diagnosed with a unicornuate uterus with a non-communicating functional rudimentary horn with grade 3 endometriosis with vascular anomaly who was managed surgically. Metrics References Grimbizis GF, Sardo ADS, Saravelos SH, Gordts S, Exacoustos C, Schoubroeck DV, et al. The Thessaloniki ESHRE/ESGEconsensus on diagnosis of female genitalanomalies. Human Reprod. 2016;31(1):2-7. DOI: https://doi.org/10.1093/humrep/dev264 Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology. 2023. Available at: https:// emedicine.medscape.com/article/273534-overview #a2. Accessed on 10 November 2025. Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, et al. ASRM müllerian anomalies classification 2021. Fertil Steril. 2021;116(5):1238-52. DOI: https://doi.org/10.1016/j.fertnstert.2021.09.025 Ludwin A, Lindheim SR. Unicornuate uterus and the noncommunicating functional horn: continued debate on the diagnosis, classification, and treatment. Fertil Steril. 2020;113(4):772-3. DOI: https://doi.org/10.1016/j.fertnstert.2020.01.006 Arab M, Mehdighalb S, Khosravi D. Functional Rudimentary Horn as a Rare Cause of Pelvic Pain: A Case Report. Iran Red Crescent Med J. 2014;16(10). DOI: https://doi.org/10.5812/ircmj.19351 Jayasinghe Y, Rane A, Stalewski H, Grover S. The Presentation and Early Diagnosis of the Rudimentary Uterine Horn: Obstet Gynecol. 2005;105(6):1456-67. DOI: https://doi.org/10.1097/01.AOG.0000161321.94364.56 Herlin MK, Petersen MB, Brännström M. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a comprehensive update. Orphanet J Rare Dis. 2020;15(1):214. DOI: https://doi.org/10.1186/s13023-020-01491-9 Yadav R, Srivastava A. Intractable Dysmenorrhea in Adolescents: A Series of Two Cases of Laparoscopic Rudimentary Horn Excision. J Case Rep. 2019;15-8. DOI: https://doi.org/10.17659/01.2019.0005 Madhu AR, Shipra K. A Case of Non-Communicating Uterine Horn Containing Functional Endometrium. Gynecol Obstet. 2015;05(09). DOI: https://doi.org/10.4172/2161-0932.1000320 Bhadwal A, Sharma S, Ranga S. Uterine rudimentary horn and ovarian endometriosis with a special emphasis on VACTERL association: a report of two cases. Int J Reprod Contracept Obstet Gynecol. 2024;13(7):1868-72. DOI: https://doi.org/10.18203/2320-1770.ijrcog20241793