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Click 13 year old female with uterus didelphys, unilateral distal vaginal agenesis, and ipsilateral renal agenesis. Transabdominal ultrasound. Transverse sections demonstrated widely divergent uterine corpi, raising the index of suspicion for uterine duplication anomaly. Normal appearing uterus on the right. Distended endometrial cavity identified on the left. Complex cyst superior the urinary bladder was initially presumed to be a complex left ovarian cyst. (Protocol: 3.5 MHz curvilinear transducer (Phillips).

Click 13 year old female with uterus didelphys, unilateral distal vaginal agenesis, and ipsilateral renal agenesis. Axial T2 noncontrast demonstrates a normal right uterine horn. Distended lower uterine segment with blood products and distended tubular structure are noted extending to the expected left adnexa superior to the distended left uterus, compatible with hematosalpinx. These findings are located superior to the bladder. (Protocol: 1.5 Tesla MRI (GE Signa Excite), TR/TE: 2800/80, 5mm slice thickness, non-contrast).

Click 13 year old female with uterus didelphys, unilateral distal vaginal agenesis, and ipsilateral renal agenesis. Coronal long axis non-fat saturated FSE T2. After administration of sterile saline plus sterile ultrasound gel into the vaginal fornix via a small sterile catheter high T2 signal extended from the vaginal fornix into a normal appearing cervix and uterine horn confirming patency on the right and corresponding with a prior physical exam performed by the surgeon. Note blind-ending uterus and lower uterine segment. (Protocol: 1.5 Tesla MRI (GE Signa Excite), TR/TE: 4000/110, 5mm slice thickness, non-contrast).

Click 13 year old female with uterus didelphys, unilateral distal vaginal agenesis, and ipsilateral renal agenesis. Coronal long axis non-fat saturated FSE T2. Left uterine horn and distended, blind-ending left lower uterine segment ended in intermediate signal tissue at the superior aspect of what appeared to be the vagina as noted on prior MRI. Normal right uterine horn and blind-ending uterus are displayed. (Protocol: 1.5 Tesla MRI (GE Signa Excite), TR/TE: 4000/110, 5mm slice thickness, non-contrast).