MR imaging of uterus didelphys transverse vaginal septum causing hematometrocolpos and renal agenesis

The association of uterus didelphys and unilateral blind vagina with ipsilateral renal agenesis is an infrequent urogenital malformation distinguished by a lesion of the mesonephric duct. In most patients, symptoms are present at the beginning of the menstrual cycle because a transverse vaginal septum on one side obstructs the flow of menses, which consequently collect. Magnetic resonance imaging allows a precise delineation of this congenital abnormality, clearly demonstrating the transverse vaginal septum with hematometrocolpos and uterus didelphys. Extending the magnetic resonance study to the abdomen and employing coronal sections with a wide field of view is important to search for associated renal agenesis or hypoplasia.