Presentation
Amenorrhea with pelvic pain.
Patient Data
Two separated and divergent uterine horns (angle = 95°) with a fundal cleft at 22 mm and intercornual distance at 52 mm. The endometrial cavities as well as the cervices are uniformly separate with no evidence of communication between them in keeping with a uterus didelphys.
Blood-filled distended vagina of high signal on T1, and low signal on T2 in keeping with a hematocolpos.
Normal appearance of the ovaries.
Case Discussion
MRI features of hematocolpos in an adolescent with uterus didelphys (Müllerian duct anomaly class III).
Hematocolpos is defined as a blood-filled dilated vagina due to an accumulation of menstrual blood in the setting of an anatomical obstruction, usually an imperforate hymen.
Other causes include vaginal septum including a transverse vaginal septum which is seen in 75% of cases of uterus didelphys.
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