Laparoscopic uterine anastomosis for traumatic separation of the cervix from the uterine corpus caused by closed pelvic fracture: case report and literature review

Abstract

Primary amenorrhea caused by separation of the cervix from the uterine body resulting from pelvic trauma is exceptionally rare. This case report describes the diagnosis and successful laparoscopic approximation of traumatic separation of the cervix from the uterine corpus. A 16-year-old girl who was involved in a car accident at age 2 years had primary amenorrhea and cyclic abdominal pain. A closed pelvic fracture was managed nonsurgically, with an uneventful recovery. Since age 13 years, the patient has been experiencing cyclic abdominal pain. Ultrasonography suggested a 5-cm left adnexal mass. Diagnostic laparoscopy revealed complete separation of the uterine corpus from the cervix, and an endometrioma in the left ovary. The uterine corpus was approximated to the cervix with circumferentially placed sutures under direct laparoscopic guidance. The endometrioma was resected concomitantly. Normal cyclic menstruation resumed 2 months postoperatively, without cyclic abdominal pain. This case report demonstrates successful laparoscopic approximation of traumatic separation of the uterine corpus from the cervix, manifested as primary amenorrhea.