RUPTURE ECTOPIC PREGNANCY AT 14 WEEKS IN NONCOMMUNICATING RUDIMENTARY HORN OF UNICORNUATE UTERUS: A CASE REPORT

Rudimentary horn pregnancy is rare but, if occurs it gives a grave risk to the health of the pregnant woman. In most cases it presents in the form of ectopic pregnancy. Despite availability of good USG facility, it is very difficult to timely diagnose rudimentary horn pregnancy. Confirmatory diagnosis made only by laparoscopy or during laparotomy. In the rudimentary horn the constitution of the muscle wall thickness is variable so the pregnancy can be accommodated until late pregnancy. Here we present a case of 24 years female Gravida3 Para2 Live2 with 14 weeks pregnancy presented to us in shock with clinical features of ruptured ectopic pregnancy. On laparotomy we found non-communicating rudimentary horn rupture with dead fetus in peritoneal cavity

Unicornuate uterus with functional non communicating rudimentary horn: a refractory cause of dysmenorrhea

Mullerian duct anomalies are rare. Unicornuate uterus with a non-communicating rudimentary horn is a rare type of mullerian duct anomaly which occurs due to defective fusion of malformed duct with contralateral duct. The incidence is approximately 1:100000. Patient usually remain asymptomatic due to the absence of functional endometrium in most of the cases. If the rudimentary uterine horn has an endometrium lined uterine cavity and doesn’t communicate externally then the signs and symptoms of obstructed menstruation appears, as soon as menarche begins. It will be associated with severe dysmennorhoea and hematometra. Other complications may be abdominal lump, chronic pelvic pain, infertility, endometriosis, adenomyosis and ectopic pregnancy in rudimentary horn. Authors are presenting a case of refractory dysmenorrhea with lump abdomen in a patient with unicornuate uterus with functional non communicating horn. In a patient with refractory dysmenorrhea mullerian duct anomaly should be kept as differential diagnosis.

Laparoscopic management of ruptured non communicating rudimentary horn in second trimester of pregnancy

Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in rudimentary horn is rare occurrence with incidence of less than 1 in 150,000. Prerupture diagnosis of rudimentary horn pregnancy with USG is technically difficult, with sensitivity of 30%. It is often not diagnosed unless it terminates by rupture in the second trimester leading to catastrophic haemorrhage and hence high incidence of maternal mortality. Management of such cases is a challenge till today due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management is life saving in such cases. Here we present a case of ruptured non-communicating rudimentary horn pregnancy at 15 weeks presenting in our emergency department as a case of pain abdomen. Laparoscopic resection of the rudimentary horn was performed for the patient.

Endoscopy in the management of a rudimentary non-communicating functional horn

Mullerian anomalies are developmental malformations of the female reproductive tract, often diagnosed late. They are classified into numerous types like a septate uterus, bicornuate or unicornuate uterus etc. A rudimentary non-communicating functional horn is a rare variant of a unicornuate uterus. It may present with a wide spectrum of symptoms like severe dysmenorrhea, infertility, lump in abdomen or rarely maybe diagnosed with a ruptured ectopic in the horn. The diagnosis of this entity is a difficult and challenging. Authors present a case of a young adolescent diagnosed with this Mullerian anomaly, the role of hysteroscopy in confirmation of diagnosis and the management of the patient by laparoscopy successfully. The patient was completely relieved of her symptoms post-surgery.

Cholesteatoma and hydrocephalus associated to a third ventricle meningioma in a cat / Colesteatoma e hidrocefalia associados a meningioma em terceiro ventrículo em um gato

ABSTRACT: Meningiomas are neoplasms that commonly involve the central nervous system of cats, while cholesteatomas are nodular granulomatous chronic lesions within the choroid plexus that are rarely reported in cats. This study described a case of cholesteatoma and non-communicating hydrocephalus associated to a third ventricle meningioma in a cat. Clinically, the cat had a 2-year history of behavioral changes, photophobia and motor incoordination. At the necropsy, a tan-brown mass totally occluded the third ventricle, causing a severe dilation of the lateral ventricles (non-communicating hydrocephalus). Microscopically, the mass was composed by a neoplastic proliferation of spindle cells arranged in bundles, containing in the center psammomatous bodies (meningioma), while in the adjacent areas a cholesteatoma was observed, which was characterized by multiple cholesterol cleft formation, hemosiderosis and associated granulomatous inflammation. At immunohistochemistry (IHC), neoplastic cells had a marked immunostaining for vimentin, while were negative for cytokeratin and S100. The diagnosis of transitional meningioma occurring in association to cholesteatoma and non-communicating hydrocephalus in a cat was obtained mainly by the histological and IHC features. These are important methods to distinguish this condition from other neurological disorders in cats.

RESUMO: Meningiomas são neoplasias que comumente envolvem o sistema nervoso central de gatos, enquanto colesteatomas são formações nodulares granulomatosas raramente descritas nessa espécie e que resultam de lesões crônicas em plexo coroide. O objetivo desse trabalho é descrever um caso de meningioma em terceiro ventrículo culminando com a formação de colesteatoma e hidrocefalia não comunicante em um gato. Clinicamente, o gato apresentava alteração de comportamento, fotofobia e incoordenação motora durante dois anos. À necropsia apresentava uma massa acastanhada no terceiro ventrículo que provocava oclusão total do mesmo e acentuada dilatação de ventrículos laterais (hidrocefalia não comunicante). Microscopicamente, havia proliferação neoplásica de células fusiformes arranjadas em feixes com a formação de corpos psamomatosos (meningioma), e em área adjacente havia múltiplas fendas de colesterol e hemossiderose com infiltrado granulomatoso (colesteatoma). À imuno-histoquímica (IHQ), foi observada marcação positiva para vimentina e negativa para citoqueratina e S100 nas células neoplásicas. Os exames histológicos e de IHQ contribuíram para a confirmação do diagnóstico de meningioma transicional associado à formação de colesteatoma e hidrocefalia não comunicante, e são métodos importantes para diferenciar de outras afecções que cursam com quadro clínico neurológico em felinos.

Scar endometriosis – A clinical rarity.

Scar endometriosis is a rare occurrence. Endometriosis is presence of endometrium at ectopic sites, other than the uterine cavity. Though the common sites of endometriosis are pelvic structures, extra pelvic endometriosis is occasionally seen. But presence of endometriosis in previous incision scars is extremely rare. Endometriosis in abdominal incision sites following Cesarean scions, hysterectomy, ovarian endometrioma removal are described. Very few cases of endometriosis at episiotomy site are also described in literature. This case report describes two such cases of scar endometriosis. The first case had scar endometriosis following a laparotomy done for rudimentary horn pregnancy. The second case had endometriosis in the scar of previous laparscopic surgeries, performed for ovarian endometrioma.

Rupture of Term Noncommunicating Rudimentary Horn of Uterus.

Pregnancy in noncommunicating rudimentary horn is rare. It occurs following transperitoneal migration of sperms or zygote. Uterine rupture usually occurs in 70-80% cases in the second trimester by 20 weeks. Neonatal survival in rudimentary horn pregnancy is poor occurring in only about 11% of cases.

Pregnancy in rudimentary horn of uterus.

A 20-year-old primigravida with 3 months amenorrhea presented with complaints of acute abdominal pain. Her vital systemic parameters were stable. On vaginal examination, the patient was provisionally diagnosed of right cornual ectopic pregnancy, which was confirmed sonographically, and taken up for surgery. There was moderate hemoperitoneum and rupture of right horn of uterus with products protruding. The rudimentary horn was excised. The patient was discharged and advised contraception and follow-up.

Laparoscopic excision of uterine horn in case of unicornuate uterus firmly attached with non-communicating rudimentary horn / 대한산부인과내시경학회지

Unicornuate uterus is a very rare uterine anomaly caused by developmetal failure of Mullerian duct. This anomay is associated with various degrees of rudimentary horn, which is connected with fibrous band or firmly attached to unicornuate uterus. Different method of operation may be applied according to type of anatomical connection. The unicornuate uterus is commonly associated with severe dysmenorrhea, chronic pelvic pain, and pelvic mass. A case of noncommunicating rudimentary horn firmly attached to unicornuate uterus with severe dysmenorrhea was treated with laparoscopic excison of uterine horn and is presented with brief review of literature.

Noncommunicating Spinal Extradural Meningeal Cyst in Thoracolumbar Spine

Spinal extradural meningeal cyst has been rarely reported, whose etiologies are assumed to be the communication of cerebrospinal fluid (CSF) between intradural subarchnoid space and cyst due to the congenital defect in dura mater. Although the CSF communication due to this defect can be found, in most case, few cases in which there is a lack of the communication have also been reported. We report a case of the huge extradural meningeal cyst occurring in the thoracolumbar spine (from T10 to L2) where there was a lack of the communication between the intradural subarachnoid space and cyst in a 46-year-old man who presented with symptoms that were indicative of progressive paraparesis and leg pain. The patient underwent laminectomy and cyst excision. On intraoperative findings, the dura was intact and there was a lack of the communication with intradural subarachnoid space. Immediately after the surgery, weakness and leg pain disappeared shortly.

A Laparoscopic Resection of A Noncommunicating Rudimentary Uterine Horn With Pelvic Endometriosis / 대한산부인과학회잡지

Noncommunicating uterine horns are rare, occasionally presenting with functional endometrial cavities, Surgical removal of the noncommunicating horn is commonly performed to prevent endometriosis and rupture of a pregnancy in these patient. We report a case of rudimentary horn with pelvic and appendicular endometriosis treated by laparoscopic resection of those lesions.

The effects of local factors in testicular histology in patients with non-communicating hydrocele

The effect of local factors, e.g. intracavitary hydrocele pressure, hydrocele fluid volume and specific gravity, temperature and thickness of the tunica vaginalis testis, on spermatogenesis was investigated. A total of 17 patients with non-communicating hydrocele were included in this study. Sixteen patients had decreased spermatogenic activity which we believe was influenced by the increase pressure contributed by the above mentioned factors. It is possible that hydrocele surgery, often done for cosmetic purposes, may in fact contribute to the preservation of spermatogenic function.

A Case of Unruptured Non - communicating Rudimentary Horn Pregnancy Progressed to the Third Trimester of Pregnancy / 대한산부인과학회잡지

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.

Gastric Duplication

Gatric duplication is a rare congenital anomaly. Thus for about 90 cases of gastric duplication have been recorded in the literature. It is less frequent than small intestinal or eosphageal duplication, and accounts for only 3.8% of all gastrointestinal tract duplication. Most gastric duplications are seen during the first year of life. Palpable abdominal mass and gastric outlet obstruction in infancy are most common presentation. We experienced a case of non-communicating gastric duplication. A 12-year-old girl visited St. Mary's Hospital because of indigestion, intermittent vomiting, and left upper quandrant pain for about 40 days. She have had intemittent abdominal pain with concomitant increased level of amylase since 5 years old. Physical examination showed a hen's egg sized palpable mass on left upper quadrant of the abdomen. Upper GI series and barium enema revealed only indentation of duodenal C-loop, and sonogram and abdominal CT demonstrated isolated cystic mass along the greater curvature of gastric antrum. She had taken an operation under the impression of pancreatic pseudocyst. Operation revealed a cystic mass, located along the greater curvature. There was no pathologic change in the pancreas. Microscopic findings of the cyst wall revealed normal gastric mucosal lining and common muscle layer, shared with gastric antral muscle layer.