Laparoscopic removal of a rudimentary uterine horn in a previously hysterectomized patient

The unicornuate uterine anomaly is often difficult to diagnose and usually low on the list of differential diagnoses for pelvic pain and dysmenorrhea. The authors present a case of a rudimentary uterine horn as a cause for continued pelvic pain and dysmenorrhea in a previously hysterectomized woman.

A 43-year-old woman, gravida 1, para 1, presented for evaluation of right lower quadrant pain of several years' duration. Her past surgical history was significant for multiple prior laparoscopies and a vaginal hysterectomy. Radiographic studies revealed a mass in the right lower quadrant. Laparoscopy revealed a solid mass in the right pelvis that was diagnosed as a rudimentary uterine horn.

Uterine anomalies, although uncommon, should be thought of as part of the differential diagnosis for pelvic pain and dysmenorrhea. A thorough inspection of the pelvis should be performed at the time of any operative procedure for abdominal pain.