LAUSR

A 15-year-old female patient was admitted to the hospital with right lower quadrant pain and nausea for 2 days. Her complaints were not accompanied by any additional symptoms such as fever, diarrhea, or constipation. Physical examination revealed normal blood pressure (120/80 mmHg), normal breathing (15 per minute), and pulse rate (82 per minute). Tenderness without abdominal guarding was detected in the right lower quadrant. Laboratory examination revealed elevated white blood cell count (17.9 K/μL, normal range; 4–10 K/μL), neutrophil count (9.3 K/μL, normal range 2–7 K/μL), and Creactive protein (64 mg/L, normal range; 0–5 mg/L) value. Other values were within normal values. Urine analysis results were within normal limits. She had no history of chronic disease or previous surgery. Abdominal ultrasonography (US) was performed with a preliminary diagnosis of the acute abdomen and revealed a cystic mass measuring 36 × 16 mm in the right adnexal region and the absence of the right kidney. Left kidney dimensions were 125 × 52 × 17 mm (craniocaudal × anteroposterior × cortical thickness) and showed compensatory hypertrophy. However, the appendix was not visualized. For further investigation, contrast-enhanced abdominal computed tomography (CT) was performed and demonstrated right kidney agenesis, double uterine contour, and cystic mass in the right adnexal region (Fig. 1). In addition, the appendix was found to be normal. Magnetic resonance imaging (MRI) was performed for the cystic adnexal lesion and probable uterine anomaly. Pelvic MRI showed uterus didelphys and right hemivaginal cystic lesion compatible with obstructed right hemivagina (Fig. 2).