​CASE 5

Courtesy of Saba 1 Medical Clinics Complex, Jeddah, Saudi Arabia

37-years-old female with infertility

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CASE 5 ANSWER

Unicornuate versus didelphys Uterus

On this hysterosalpingogram, contrast fills a relatively small uterine cavity (red arrow) that is shifted to the left, and that has a fusiform shape that tappers into a single fallopian tube with free spillage of contrast into the peritoneal cavity (yellow arrow)

Key Points

• Unicornuate and didelphys are Mullarian duct abnormalities.

• Unicornuate: Fusiform cavity drains into one tube and may have a rudimentary contralateral horn that may or may not have an endometrial cavity, and that may or may not communicate with the central cavity.

• Didelphys: Duplication of the uterine cavity with each draining onto respective fallopian tubes. Cannulating one orifice may result in the above appearance that may confuse for a unicornuate anomaly.