Abstract: Dysmenorrhea in is seen in 41-91.5% adolescent girls and is mostly due to primary dysmenorrhea. Endometriosis is the most common cause of secondary dysmenorrhea and very rarely is due to obstructive mullerian anomalies.
An adolescent girl with unrelenting dysmenorrhea with frequent hospital visits, had an obstructed accessory uterine horn on ultrasound and was confirmed on MRI scans. She underwent successful laparoscopic excision and was relieved of her dysmenorrhea.
These lesions are rare but can cause severe dysmenorrhea not responding to medical management and unrecognized lesions can lead to infertility, ectopic pregnancy in accessory horn with catastrophic complications and infertility. They are the most commonly detected during 3rd decade of life, with very few cases being diagnosed and successively treated in adolescent girls. Early recognition and laparoscopic excision can relieve the dysmenorrhea and preserve fertility in these patients.