Unicornuate Uterus with a Non-Communicating Rudimentary Horn in a Palestinian Patient with Familial Mediterranean Fever: Case Report

Osama Darras, Amal Abu Osba, Khalid Massarweh
In: AL-Kindy College Medical Journal · 2023 · vol. 19(1) , pp. 127–130 · doi:10.47723/kcmj.v19i1.936 · W4367556140
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This case report describes a 14-year-old Palestinian patient with familial Mediterranean fever who experienced chronic pelvic pain due to a unicornuate uterus with a non-communicating rudimentary horn, which improved following surgical intervention.

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This case report describes a 14-year-old Palestinian female with Familial Mediterranean Fever who presented with severe chronic pelvic pain and was initially misdiagnosed with an endometrioma. Surgical intervention revealed a unicornuate uterus with a functional, non-communicating rudimentary horn, which was subsequently removed. The procedure resulted in marked improvement of the patient's pain attacks and daily quality of life, highlighting the importance of considering Mullerian duct anomalies in differential diagnoses for young women with unexplained pelvic pain or infertility. This paper is centrally about endometriosis — specifically, it discusses how occult non-communicating uterine horns are frequently misdiagnosed as endometriomas, leading to inappropriate surgical interventions before the correct anatomical anomaly is identified.

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Abstract

Rudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unicornuate uterus with right functional non-communicating rudimentary horn. The patient was followed up and mentioned marked improvement of her previous pain attacks. Her family members observed marked improvement in her usual daily activities and quality of life. Occult non-communicating uterine horn are frequently misdiagnosed due to its rarity and unspecific symptoms. The diagnosis of Mullerian anomalies should be added to the differential diagnoses for women with infertility, chronic abdominal and pelvic pain, and dysmenorrhea to avoid the patients’ agony and to alleviate their quality of life.
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Unicornuate Uterus with a Non-Communicating Rudimentary Horn in a Palestinian Patient with Familial Mediterranean Fever: Case Report DOI: https://doi.org/10.47723/kcmj.v19i1.936Keywords: Mullerian Duct Anomalies., familial Mediterranean feverAbstract Rudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unicornuate uterus with right functional non-communicating rudimentary horn. The patient was followed up and mentioned marked improvement of her previous pain attacks. Her family members observed marked improvement in her usual daily activities and quality of life. Occult non-communicating uterine horn are frequently misdiagnosed due to its rarity and unspecific symptoms. The diagnosis of Mullerian anomalies should be added to the differential diagnoses for women with infertility, chronic abdominal and pelvic pain, and dysmenorrhea to avoid the patients’ agony and to alleviate their quality of life. Downloads Published Issue Section License Copyright (c) 2023 AL-Kindy College Medical Journal This work is licensed under a Creative Commons Attribution 4.0 International License.

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endometriomachronic_pelvic_paindysmenorrheainfertility

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