The patient A. was admitted to the Center from regional out-patient department with the diagnosis: algodysmenorrhea, tumor of left lower quadrant of abdominal cavity.
The patient was followed-up from early childhood because of genitourinary system malformation in the form of complete duplication of left kidney, urinary incontinence, left majus and minus labia hypoplasia. She was operated two times: in 22-months age the left ureteroureteroanastomosis was done; in 13-years age she was reffered to surgery department with peritonitis. On laparotomy the left fallopian tube rupture and «chocolate-like» cysts of left ovary complicated of hemoperitoneum were found. The left adnexa were removed.
At time of examination the patient complained with recurrent left quadrant abdominal pain markedly strengthening during the menses.
 

 Fig.1  First TV scan.

Longitudinal sonogram of the uterus, it markedly deviated to the right. Endometrium corresponds to secretory phase. (LMP 25.07.98).
Right ovary is visualized posterior to the uterus. Contains the corpus luteum.
In the region of left adnexa the large complex mass with fluid - filled areas was indistinctly identified. Therefore she was undertaken the transabdominal US.
 
 

Fig.2 TA sonogram.

In the region of the left lower quadrant the second uterus was found with distended up to 25 mm uterine cavity filled with inhomogeneous fluid (hematometra).
It was painfull with palpation. There was no visible communication between left cervix and vagina.
 
 

Fig.3  Sonogram of left kidney.

Color Doppler reveales an additional artery to the low segment of left kidney.
 
 

Fig.4 (a) Spectral Doppler

Waveform of a main renal artery (a) and additional artery (b) showing the normal low resistance pattern.
 
 

Fig.4 (b) Spectral Doppler
 
 

Fig.5 Follow-up TA sonography (9th day of menstrual period).

Two separate utera on both sides of urinary bladder. Note that hematometra of the left uterus disappeared.
 
 
 
 

Fig.6 TV scan.

The cavity of left uterus contains only the hyperechopic material (blood clots) and no fluid. It may suggest a presence of communication of uterine cavity with vagina.
 
 

 

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