Robert’s uterus is a rare variant of septate uterus with an asymmetrical septum which divides the uterine cavity into a noncommunicating hemiuterus causing hematometra and other communicating hemiuterus with a single cervix and a normal fundal contour (U2bC3V4 ESHRE classification). It is a cause of severe dysmenorrhea in young girls. However, there is a type of Robert uterus (Type II) which does not have collection in the blind cavity and causes symptoms later, similar to our case. We describe a case of hysteroscopic septum resection (metroplasty) with laparoscopic guidance by transillumination in a case of Type II Robert’s uterus in a 25-year-old nulliparous woman. Thick muscular septum posed a surgical challenge which was supplemented by astutely utilizing laparoscopic transillumination.
Blind cavity · Endometriosis · Hematosalpinx · Mullerian anomaly · Noncommunicating horn · Obstructed horn · Pyometra · Retrograde menstruation · Severe dysmenorrheaCase Summary A 27 years old female presented to gynae OPD with foul smelling discharge per vaginum off and on for a year and was given treatment for PID (Pelvic inflammatory disease) and cervicitis. Pap smear was taken and was reported unsatisfactory due to inflammation. Colposcopy was planned later due to her bothersome complaints and suspicious looking cervix. A white worm popped out of cervix while doing colposcopy which turned out to be Trichuris trichiura. Deworming was done for the patient and her family members. Patient reported again with similar complaints and this time colposcopy and guided biopsy was done that showed Tubercular Granulomatous cervicitis hence, she was put on category I ATT (Antitubercular treatment) that relieved her symptoms and improved cervical findings.
Conclusion People living in tropical and subtropical areas are at highest risk of infection by T. trichiura. This is the first case of T. trichiura in ectopic location and first case of a live worm found in female genital tract. Previous studies have shown that helminthic infection can reactivate latent TB and aggravate the disease expression.
Trichuris trichiura · Vaginal discharge · Genital helminthiasis · Granulomatous cervicitis · TuberculosisHemorrhagic ovarian cysts (HOCs) are frequently seen in reproductive age women, developing in the luteal phase of ovulatory cycles. Giant HOCs are rare, as bleeding inside a closed space causes acute pain leading to early diagnosis. Anovulation or oligoovulation is a defining feature of polycystic ovarian syndrome (PCOS), and hence, functional cysts are uncommon in PCOS patients. This report describes a young girl with PCOS and amenorrhea, presenting with a giant hemorrhagic ovarian cyst. Most hemorrhagic cysts undergo spontaneous resolution with follow-up. Our patient presented as a surgical emergency following torsion and rupture with hemoperitoneum. Torsion causes an obstruction in the blood flow leading to infarction and loss of ovarian viability. Early diagnosis and detorsion may help to preserve ovarian function.
Hemorrhagic ovarian cyst · Corpus luteum cyst · Polycystic ovarian syndrome · Torsion · Hemoperitoneum · Whirlpool signHydrosalpinx induced torsion of the adnexa in a premenarchal child without sexual experience is a rare situation and immediate intervention is necessary. This report describes a 10-year old premenarchal female without a history of sexual intercourse who presented with left lower abdominal pain. Ultrasound imaging revealed a left adnexa with thick-walled cystic lesion measuring 5.1 × 3.7 × 2.7 cm suggestive of hydrosalpinx or para ovarian cyst. Diagnostic laparoscopic surgery showed ischaemic tubular shaped cystic left hydrosalpinx that was twisted along its own axis at the level of isthmus. Laparoscopic left salpingectomy was performed within 24 h of presentation leaving behind a healthy left ovary. Early diagnosis is important in preventing further complications including severe infection and peritonitis and to prevent complications that might affect fertility.
Hydrosalpinx · Isolated fallopian tube torsion · Adnexal torsion · Premenarchal childMyiasis is defined as the infestation of living tissue by dipterous larvae and is derived from the Greek word "Myia", which means "fly". Cases of external urogenital myiasis in the literature have been documented in women with genital malignancy, decubitus ulcers, external wounds, genital warts, and sexually transmitted diseases. We present a case of a 27-year-old unmarried, mentally subnormal lady with a history of a painful swelling in the vulva for 10 days. Local examination revealed a swelling in the left labia and an ulcer with undermined edges with live maggots inside it. The patient underwent surgical debridement and removal of maggots. Emphasis should be given to prevention of this condition to prevent re-infestation.
Maggots · Myiasis · Vulva