Horizontal uterine torsion in the setting of complete cervical and partial vaginal agenesis: a case report

OBJECTIVE: To report a case in which uterine torsion in a nulligravid female adolescent was noted upon surgical management of complete cervical and partial vaginal agenesis. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 13-year-old nulligravid adolescent female. INTERVENTION(S): Ultrasound-guided vaginal exploration, diagnostic laparoscopy, and hysterectomy. MAIN OUTCOME MEASURE(S): Uterine torsion as complication of cervical agenesis and its management. RESULT(S): Complete cervical agenesis, hematometra, and resultant 180-degree horizontal uterine torsion and sacral entrapment. CONCLUSION(S): Cervical agenesis can be a risk factor for uterine torsion. Hysterectomy is a common treatment due to resultant hematometra, pelvic pain, and severe endometriosis, although rare case reports show success with uterovaginal recanalization in cases with cervical dysgenesis.