Ultrasound Clinics: Sonographic clues to m?llerian anomalies

Müllerian anomalies usually come to light in women of reproductive age who are being worked up for recurrent pregnancy loss. In rare situations, they are found in very young girls who present with either primary amenorrhea or pain. Most of the ultrasound pictures shown here have line drawings superimposed over them to facilitate understanding of the U/S picture.

An atypical case An 11-year-old girl presented to the emergency department with a 10-day history of abdominal pain and constipation. She denied fever, chills, cramping, or abnormal vaginal bleeding. She was not sexually active.

The patient's gynecological history was significant for her last menstrual period 10 days before she presented to the emergency room. The girl gave a history of dysmenorrhea, which was relieved by over-the-counter pain medication. Menarche had occurred 3 months before admission and she had regular periods every 28 days. Medical and family histories were unremarkable.