A RARE CASE OF CERVICAL ATRESIA WITH PARTIAL VAGINAL ATRESIA

Abstract

Atresia of the uterine cervix is a rare Mullerian malformation which may be associated with vaginal agenesis. It is very rare in incidence, less than 60 cases is reported in literature so far. 24 Year old unmarried girl presented with primary amenorrhoea. She was already evaluated for the same in 2007, during which she was diagnosed as lower vaginal atresia and vaginoplasty has been performed then. She was advised regular vaginal dilatation with a mould. But patient had not resumed her menstruation in spite of dilatation for six months and she lost follow up further. She presented again in 2014 July with primary amenorrhoea and severe cyclical abdominal pain restricting her from activities of daily living. Per abdomen examination revealed uterus 24 weeks size. Investigation revealed bulky uterus with adenomyosis, hematometra, bilateral hematosalphinx, and bilateral                  endometriotic cyst. Intra op finding revealed complete cervical atresia and hysterectomy with bilateral removal of                    endometriotic cysts after leaving behind ovarian tissue. Mc Indo redo vaginoplasty done. To conclude, diagnosis of           uterine cervical atresia requires higher clinical suspicion.  Diagnosis should be made as early as possible to avoid           complication that may lead to aggressive surgery such as adnexectomy or hysterectomy. Though the above patient presented to us with complications, maximum efforts had been taken to leaving behind ovarian tissue.