{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:04:04Z","timestamp":1784113444236,"version":"3.55.0"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ovarian apoplexy is a rare but potentially life\u2010threatening gynecologic emergency characterized by acute ovarian hemorrhage and hemoperitoneum. We report the case of an 18\u2010year\u2010old nulligravida who presented with sudden worsening lower abdominal pain and was initially found on imaging to have a hemorrhagic left ovarian cyst, hemoperitoneum, and an incidental right pelvic ectopic kidney. Shortly after admission, she developed hemorrhagic shock with a significant drop in hemoglobin, necessitating emergency laparoscopy. Intraoperatively, approximately 1.5\u2009L of hemoperitoneum was evacuated, and a ruptured hemorrhagic left ovarian cyst was identified and treated. The procedure unexpectedly revealed a rare congenital triad consisting of a left unicornuate uterus, right pelvic renal ectopia, and right ovarian maldescent with a partially malpositioned fallopian tube. The patient recovered uneventfully following surgical management and blood transfusion. This rare case highlights the coexistence of life\u2010threatening ovarian apoplexy with multiple previously unrecognized congenital urogenital anomalies, creating diagnostic and surgical challenges in the emergency setting. It underscores the importance of considering underlying anatomical variations in adolescents presenting with acute abdominal pain and hemoperitoneum, as well as the value of prompt laparoscopic intervention for both definitive treatment and accurate anatomical assessment in hemodynamically unstable patients.<\/jats:p>","DOI":"10.1002\/ijgo.71209","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:11:41Z","timestamp":1784110301000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Life\u2010threatening ovarian apoplexy unmasking a rare congenital triad: Unicornuate uterus, pelvic renal ectopia, and ovarian maldescent"],"prefix":"10.1002","author":[{"given":"Hassan","family":"Barakat","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medical Sciences Lebanese University  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3764-8913","authenticated-orcid":false,"given":"Fatima","family":"Barakat","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy Lebanese University  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Awala","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension American University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Saber","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Saint George University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Kalach","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Al Zahraa Hospital  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Al Alam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Al Hayat Hospital  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"3","key":"e_1_2_6_2_1","first-page":"230","article-title":"Ovarian apoplexy: clinical and therapeutic aspects","volume":"127","author":"Barel O","year":"2014","journal-title":"Int J Gynecol Obstet"},{"issue":"5","key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.bpobgyn.2009.02.001","article-title":"Diagnosis and management of ovarian cyst accidents","volume":"23","author":"Bottomley C","year":"2009","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1182355","article-title":"Case report: rudimentary uterine horn with ovarian endometriosis manifested as pelvic ectopic kidney","volume":"10","author":"Yin SF","year":"2023","journal-title":"Front Med (Lausanne)"},{"issue":"5","key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.18203\/2320-1770.ijrcog20201826","article-title":"Ovarian maldescent: a case report and discussion","volume":"9","author":"Mukherjee S","year":"2020","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"issue":"6","key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1097\/01.AOG.0000161321.94364.56","article-title":"The presentation and early diagnosis of the rudimentary uterine horn","volume":"105","author":"Jayasinghe Y","year":"2025","journal-title":"Obstet Gynecol"},{"issue":"2","key":"e_1_2_6_7_1","first-page":"411","article-title":"Coexisting unicornuate uterus and pelvic ectopic kidney: a rare case","volume":"41","author":"Elmas B","year":"2016","journal-title":"Cukurova Med J"},{"issue":"2","key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.51559\/inajperinatol.v3i2.22","article-title":"A case report: ovarian apoplexy and ectopic pregnancy at once","volume":"3","author":"Santoso MI","year":"2022","journal-title":"Indones J Perinatol"},{"issue":"11","key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s11934-018-0840-x","article-title":"Advanced imaging for the diagnosis and treatment of coexistent renal and M\u00fcllerian abnormalities","volume":"19","author":"Coleman AD","year":"2018","journal-title":"Curr Urol Rep"}],"container-title":["International Journal of Gynecology &amp; 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