{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:05:40Z","timestamp":1771473940827,"version":"3.50.1"},"reference-count":12,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:00:00Z","timestamp":1709337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Accurate diagnosis of M\u00fcllerian duct anomalies (MDA) remains a clinical challenge even by direct surgical inspection. Although obstetrical complications are more frequent in women with MDA, some subtypes allow normal reproduction, further delaying the diagnosis. Unicornuate uterus with a rudimentary non-communicating functioning horn is a rare form of MDA, susceptible to many gynecologic and obstetric complications such as miscarriages, premature birth, hematosalpinx, endometriosis, and chronic pelvic pain. We present an entire case pictorial assay including preoperative imaging as well as the surgical correction of the uterine anomaly and the associated complication of an occult unicornuate right uterus with rudimentary non-communicating functioning left horn (Class U4aC0V0\/ European Society of Human Reproduction and Embryology\/European Society of Gastrointestinal Endoscopy Classification) and its natural evolution following a previous incomplete surgical treatment. The patient had an emergency left adnexectomy for hematosalpinx and ovarian endometrioma at her local county hospital. After five years, the patient presented with severe dysmenorrhea and abdominal endometriosis due to blocked retrograde menstruation from a rudimentary, non-communicating functioning horn. Surgical treatment with the resection of the rudimentary uterine horn, together with the abdominal wall endometriosis lesions, was carried out with good outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics14050532","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T08:03:47Z","timestamp":1709539427000},"page":"532","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spontaneous Fistula and Abdominal Wall Endometriosis Due to Occult Existence of Unicornuate Right Uterus with Rudimentary Non-Communicating Functioning Left Horn"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8162-4103","authenticated-orcid":false,"given":"Gheorghe","family":"Cruciat","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3755-320X","authenticated-orcid":false,"given":"Adelina","family":"Staicu","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Florian","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8567-1246","authenticated-orcid":false,"given":"Georgiana","family":"Nemeti","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Sachelaru","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Andras","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7744-0501","authenticated-orcid":false,"given":"Daniel","family":"Muresan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology I, Mother and Child Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,2]]},"reference":[{"key":"ref_1","first-page":"437","article-title":"Endometrium of cavitary rudimentary horns in unicornuate uteri","volume":"75","author":"Fedele","year":"1990","journal-title":"Obs. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.jmig.2022.04.008","article-title":"Unicornuate Uterus with Noncommunicating Rudimentary Horn (Class U4aC0V0\/ESHRE\/ESGE Classification) and a Communicating Bladder Endometriotic Nodule","volume":"29","author":"Giampaolino","year":"2022","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1093\/oxfordjournals.humrep.a019588","article-title":"Incidence of M\u00fcllerian defects in fertile and infertile women","volume":"12","year":"1997","journal-title":"Hum. Reprod. Oxf. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/0028-2243(92)90043-X","article-title":"The unicornuate uterus: Clinical implications","volume":"47","author":"Donderwinkel","year":"1992","journal-title":"Eur. J. Obs. Gynecol. Reprod. Biol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e242874","DOI":"10.1136\/bcr-2021-242874","article-title":"Unicornuate uterus with a functional non-communicating horn in adolescent","volume":"14","author":"AJalil","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13256-020-02636-x","article-title":"An unprecedented occult non-communicating rudimentary uterine horn treated with laparoscopic excision and preservation of both fallopian tubes: A case report and review of the literature","volume":"15","author":"Gitas","year":"2021","journal-title":"J. Med. Case Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Obeidat, R.A., Aleshawi, A.J., Tashtush, N.A., and Alsarawi, H. (2019). Unicornuate uterus with a rudimentary non-communicating cavitary horn in association with VACTERL association: Case report. BMC Womens Health, 19.","DOI":"10.1186\/s12905-019-0768-4"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/humrep\/det098","article-title":"The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies","volume":"28","author":"Grimbizis","year":"2013","journal-title":"Hum. Reprod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.fertnstert.2021.09.025","article-title":"ASRM m\u00fcllerian anomalies classification 2021","volume":"116","author":"Pfeifer","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/j.1447-0756.2005.00278.x","article-title":"Case of iatrogenic dysmenorrhea in non-communicating rudimentary uterine horn and its laparoscopic resection","volume":"31","author":"Tanaka","year":"2005","journal-title":"J. Obs. Gynaecol. Res."},{"key":"ref_11","first-page":"308476","article-title":"Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: A case report","volume":"2012","author":"Thakur","year":"2012","journal-title":"Case Rep. Obs. Gynecol."},{"key":"ref_12","first-page":"e37959","article-title":"A Case Report on a Left Unicornuate Uterus with Communicating Right Rudimentary Horn Associated with Hematometra and Hematosalpinx","volume":"15","author":"Suryawanshi","year":"2023","journal-title":"Cureus"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/5\/532\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:08:25Z","timestamp":1760105305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/5\/532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,2]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["diagnostics14050532"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14050532","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,2]]}}}