Minimally Invasive Removal Of The Rudimentary Horn Of the Uterus

In the video it is showed a rudimentary uterine horn-an uncommon and life-threating condition. High risk of bleeding or tear of the uterus can even lead to a death of a pregnant woman. The patient is a 24-year-old female, examined with imaging and lapaoscopic intervention. A solitary left kidney, bicornuate uterus with the presence of rudimentary right horn, a septum in a vagine (transversal) as well as reflux menstruation causing endometriosis, were detected. After removal of vaginal septum, the singolary cervix was revealed. As the endometriosis and dismenorrhea therapy, the patient was given the oral contraceptives. In 2009 an MRI exam was done and showed a partial longitudinal vaginal septum covering right cervix and semilateral horn. In 2010 the patient was pregnant due to contraception failure (7 week of gestation). MRI and ultrasound exams were ordered and revealed left ovarian corpus luteum with a pregnancy in the right horn as well as a 1mm myometrium thinning due to gestational sac. A laparoscopic intervention of removal of right rudimentary horn together with Fallopian tube was done. The pregnancy remained intact. The duration of the surgery was 125 min and the volume of lost blood was about 75 ml. The woman went home the same day. This cases reminds of the risk of transperitonal ovum migration, when captured by the contralateral Fallopian tube, possibility of uterus tear and shows the surgical excision of the right horn without damaging the pregnancy. Authors: A. Karim Nawfal, MD, Charla M. Blacker, MD, Ronald C. Strickler, MD, David Eisenstein, MD