Diagnosis and Surgical Treatment of Uterine Isthmus Atresia: A Case Report and Review of the Literature

J Minim Invasive Gynecol. 2021 Jan;28(1):137-141. doi: 10.1016/j.jmig.2020.07.026. Epub 2020 Aug 22.

Abstract

Uterine isthmus atresia is a rare Müllerian duct anomaly occasionally diagnosed in adolescents with primary amenorrhea and cyclic abdominal pain. A case is presented of a 14-year-old female with monthly cyclic lower abdominal pain of a 2-year duration. Magnetic resonance imaging and 3-dimensional ultrasound showed separation of a 10-mm fibrotic tissue between the cervical canal and the endometrial cavity. In an attempt to preserve reproductive ability, an end-to-end anastomosis was laparoscopically performed between the cervical canal and uterine cavity. A platinol stent (WallFlex Biliary RX; Boston Scientific, Boston, MA) was placed by hysteroscopy to avoid stenosis after surgery. Laparoscopic end-to-end anastomosis is proposed to treat congenital uterine isthmus atresia.

Keywords: Anastomosis; Hematometra; Müllerian duct anomalies; Pelvic pain.

Publication types

  • Case Reports
  • Review
  • Video-Audio Media

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Abdominal Pain / surgery
  • Adolescent
  • Amenorrhea / diagnosis
  • Amenorrhea / etiology
  • Amenorrhea / surgery
  • Anastomosis, Surgical / methods
  • Cervix Uteri / abnormalities
  • Cervix Uteri / surgery*
  • Female
  • Hematometra / diagnosis
  • Hematometra / etiology
  • Hematometra / surgery
  • Humans
  • Hysteroscopy / methods
  • Laparoscopy / methods
  • Magnetic Resonance Imaging
  • Pelvic Pain / diagnosis
  • Pelvic Pain / etiology
  • Pelvic Pain / surgery
  • Spain
  • Ultrasonography / adverse effects
  • Urogenital Abnormalities / complications
  • Urogenital Abnormalities / diagnosis*
  • Urogenital Abnormalities / surgery*
  • Uterus / abnormalities*
  • Uterus / surgery

Supplementary concepts

  • Uterine Anomalies