J-LSMS 2018 | Archive | Issues 1 to 4

JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY

RADIOLOGY CASE OF THE MONTH

Uterine Rupture in the Setting of a Müllerian Duct Anomaly

Mark Rocco, MD, Chau Vo, DO, Leslee C. McNabb, MD, Jeremy Nguyen, MD

A 33-year-old woman with known twin pregnancy presents at 16 weeks gestation with a five-day history of severe intermittent abdominal pain. Vital signs are within normal limits. Physical exam reveals diffuse abdominal tenderness and intermittent rebound tenderness over the right lower quadrant.

IMAGING FINDINGS

Figure 1 is a non-contrast axial T2 weighted MR image of the pelvis demonstrating a large complex mass with mixed signal characteristic reflecting residual portions of the gestational sac and hemorrhage where the left uterine horn ruptured (arrowhead). The fetus can be identified in the right adnexa inferior to the cecum (arrow). Figures 2 and 3 are sagittal T2 weighted MR images of the pelvis which show hemorrhage along the left uterine horn and the fetus in the right adnexa, respectively (arrowheads). A single intrauterine pregnancy was also identified (image not shown).

J La State Med Soc VOL 170 MAY/JUNE 2018 95

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