Robert's uterus: a rare congenital müllerian duct anomaly causing haematometra.

To cite: Maddukuri SB, Karegowda LH, Prakashini K, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014204489 DESCRIPTION A 16-year-old girl presented with severe cyclical lower abdominal pain during menstruation, associated with vomiting, since 1year. Her menstrual cycles were regular: 3/30. Transabdominal ultrasound showed echogenic fluid collection in the endometrial cavity of the uterus, suggesting haematometra. A septated left adnexal cyst with echogenic fluid was seen, suggestive of hematosalpinx or endometriotic cyst. Suspecting a müllerian duct anomaly (MDA), a plain MRI study of the pelvis was performed with the following sequences: T2-weighted (T2W) images in coronal, axial and sagittal planes, T1W axial and T2 FS coronal images. Coronal T2W images showed thick hypointense septum in the uterus, which was asymmetrically dividing the endometrial cavity into a smaller right cavity and a larger left cavity. The lower portion of the septum was transversely oriented (figure 1) and was obstructing the left endometrial cavity leading to its distension and haematometra (figure 2). Dilation of the left fallopian tube was also seen, which was filled with haemorrhagic fluid,