Diagnosis and Laparoscopic Management of Accessory Cavitated Uterine Malformation (ACUM) in a Young Woman with Severe Refractory Dysmenorrhea: A Case Report.

Abstract

Accessory cavitated uterine malformation (ACUM) is rare congenital anomaly of uterus, there is accessory cavity with functional endometrium, which does not have any connection to main uterine cavity, due to which patient typically presents with cyclical abdominal pain which starts after menstruation. Most common complaint being severe dysmenorrhea, which may require taking pain killers every cycle for pain relief, dysmenorrhea not relieving on taking Nsaids and also hormonal treatment will always point toward suspicion of having ACUM. 3D and 4D ultrasonography can help diagnosis the ACUM, hysteroscopy and sonosalphingography could aid in diagnosis, MRI abdomen and pelvis is more specific non-invasive investigation to diagnose as in this case. Surgical excision by laparoscopy is the gold standard treatment in these cases and can offer significant relief in symptoms.