Instituto de Diagnostico por Imagen, Hospital General de Acapulco, Mexico

This is an 18-year-old-woman referred to our unit with a severe abdominal pain.  An ultrasound scan was performed and revealed a normal uterus with a rudimentary horn attached in the right side. There was a pregnancy in the rudimentary horn compatible with 16 weeks and a severe hemoperitoneum. Rupture of rudimentary horn pregnancy was suspected. Laparotomy was performed. There were a didelphic uterus, with a rudimentary horn and approximately 1500ml of blood inside the abdomen.

Right image: Note the hemoperitoneum.

Note the fetus inside the rudimentary horn above the normal uterus

The normal uterus and the fetus inside the rudimentary horn

The rudimentary horn with a rupture in the fundus

Note the rudimentary horn attached to the normal uterus

Rupture of rudimentary horn pregnancy