Nami Okamoto^1，2）, Noriko Nariyama^2）, Naohisa Kawamura^2）, Yoshito Takenaka^2）,
Takeshi Yamazaki^2）, Hiroshi Tamai^1）

Department of Pediatrics, Osaka Medical College^1）
Department of Pediatrics, Osaka Rousai Hospital^2）

　　Uterus didelphys is the most frequent malformation of the female genitalia. Most patients with this disease are diagnosed incidentally on searching for the cause of infertility. We report a case of uterus didelphys with hematometra and pyosalpinx.
　　A 15-year-old girl came to see us complaining of left lower abdominal pain and a high temperature. Our other image diagnosis showed that she had uterus didelphys with hematometra and pyosalpinx because of obstruction on the left side. We could not detect her kidney on the same side. She had experienced menstruation regularly since half a year before and had suffered from a gradual exacerbation of abdominal pain. Though fever and abdominal pain disappeared instantly after an operation to open the obstructed uterus, approached through the vagina, pyosalpinx still remained. The inflammatory symptoms reappeared on discontinuation of antibiotics ; she then underwent an extirpation of uterus, oviduct and ovary on the obstructed side. An anaerobe cultured from her ascites was thought to be the cause of infection.
　　We conclude that uterus didelphys is a possible cause of acute abdomen even in a patient with regular menstruation, and it is necessary to examine the genitals of women who have any urogenital malformation.

Keywords：Acute abdomen, Uterus didelphys, Hematometra, Pyosalpinx, Unilateral kidney