Abstract
INTRODUCTION AND IMPORTANCE: Unicornuate uterus with a rudimentary horn is type 2 of Müllerian duct anomalies. Pregnancy in the rudimentary horn of the unicornuate uterus is an uncommon presentation of an ectopic pregnancy, which is difficult to diagnose on ultrasound and can be easily missed out. Timely diagnosis and management of ectopic pregnancy in the rudimentary horn is crucial in preventing its catastrophic complications and reducing maternal morbidity and mortality. CASE PRESENTATION: This is a case report of a 25-year-old nulliparous female who presented to us with complaints of an acute tenderness in the left iliac fossa after 9 weeks of amenorrhea. Clinical examinations, radiological investigations, and exploratory mini-laparotomy revealed a unicornuate uterus with an unruptured left rudimentary horn pregnancy. Following the excision of the left rudimentary horn with ipsilateral salpingectomy and preserving the left ovary, the patient was discharged the day after in good general condition. CLINICAL DISCUSSION: Unicornuate uterus, which can be subdivided into four variants, is usually detected during the investigations of infertility, endometriosis, dysmenorrhea, and obstetrical complications. Pregnancy in the rudimentary horn is associated with a high rate of uterine rupture. Transvaginal ultrasonography, magnetic resonance imaging, hysterosalpingography, hysteroscopy, and laparoscopy can be used as diagnostic tools. The surgical approach consists of the total excision of the symptomatic rudimentary horn and the removal of the ipsilateral fallopian tube. CONCLUSION: This case highlights the importance of increased awareness about Müllerian anomalies and their radiological features among healthcare providers.