Work

Ruptured rudimentary horn pregnancy mimicking abdominal gestation: A case report

Year: 2026

Type: article

Abstract: A unicornuate uterus with a rudimentary horn, resulting from incomplete development of one of the Müllerian ducts, is a rare anomaly seen in about 0.4% of women and carries a high risk of ectopic pregnancy and uterine rupture, particularly when the horn is noncommunicating. A 27-year-old primigravida at 16 weeks' gestation presented with symptoms of hypovolemic shock and peritonitis. Abdominopelvic ultrasound demonstrated an empty uterine cavity with a viable extrauterine fetus, leading to a presumed diagnosis of abdominal pregnancy, and emergency laparotomy confirmed a ruptured pregnancy in a noncommunicating rudimentary horn with significant hemoperitoneum. Surgical removal of the horn and left fallopian tube was performed, and the patient recovered well. This case highlights a common diagnostic pitfall, as rudimentary horn pregnancy is frequently misidentified on ultrasound as an abdominal or intrauterine gestation. Recognition of key ultrasonographic features, including lack of continuity with the endometrial cavity, a myometrial mantle surrounding the gestational sac, and a vascular pedicle, may facilitate earlier diagnosis and reduce the risk of catastrophic rupture. Due to the diagnostic challenges posed by this condition, early identification using advanced imaging and prompt surgical management are critical to reducing maternal risk.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.12.030

Authors: Temesgen Getachew, Suleiman Ayalew Belay, Michael A. Negussie, Elezer Berhanu Zewde, Misganaw Abere, Solomon Berihe

Institutions: University of Gondar, Tikur Anbessa Hospital, Addis Ababa University

Language: English

Topic: Gynecological conditions and treatments

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600