Case Report
Menstrual Retention In a Robert's Uterus

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Abstract

Background

Robert's uterus is an asymmetric septate uterus. This malformation is very rare, particularly in the pediatric age group. Radiologic findings could be surprising, but are very specific. We report here a representative case.

Case

A 15-year-old patient complaining of recurrent abdominal cramps consulted the emergency department for evaluation of acute pain. Radiologic studies showed a circular lesion that had developed within the posterior wall of the uterus. The patient underwent surgery for a suspected Robert's uterus and an endometriectomy of the blind cavity was performed. There was no communication between the blind cavity and the ipsilateral fallopian tube.

Summary and Conclusion

Pediatric surgeons and gynecologists should be aware of this atypical obstructive Müllerian malformation and its management in order to avoid inappropriate management of these young patients.

Introduction

Obstructive Müllerian anomalies are frequently misdiagnosed during childhood. Robert's uterus, or an asymmetric septate uterus, is a rare cause of dysmenorrhea. We present herein a representative case of this atypical Müllerian malformation and discuss its management.

Section snippets

Case

A 15-year-old girl consulted the emergency department for severe abdominal and pelvic cramps associated with clear vomitus five days after her menses. She had regular menstrual cycles for 3 years and this was the third episode of paroxystic pain within 9 months. Clinical examination revealed pelvic tenderness without a mass and no fever. An abdominal and pelvic ultrasound scan showed a 38-mm cystic pelvic mass independent of the ovaries, which were normal. Exploration of the lumbar regions

Summary and Conclusions

Robert's uterus is a rare Müllerian malformation, first described by Robert in 1969.1 It represents an asymmetric division of the uterine cavity. The blind hemi-cavity is lined by the endometrium. Relevant data in the literature consist of case reports2, 3, 4, 5 from which it is difficult to draw conclusions. The classical clinical presentation includes dysmenorrhea attributed to menstrual bleeding and stretching of the blind cavity. In our patient, the blind cavity did not apparently

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