Torsion in a Pregnant Noncommunicating Uterine Horn - Journey from Misdiagnosis to Laparoscopic Management: A Case Report.

Pregnancy in a noncommunicating uterine horn (NCUH) is extremely rare and torsion of the pregnant horn is even rarer. Only a few cases have been reported so far. Diagnosis of such extraordinary pathologies can be challenging, and this often leads to misdiagnosis and delay in appropriate treatment. We present the case of a NCUH pregnancy which was initially misdiagnosed on ultrasound and treated with standard miscarriage management regimen. Ongoing symptoms and suspicion of sepsis prompted surgical treatment, and laparoscopy revealed a torted NCUH pregnancy, completely distinct from the unicornuate uterus. The rarity in our case was not only conception in a noncommunicating horn but also the complete torsion of the gravid horn and ipsilateral adnexa. This shows the complexities of dealing with rare uterine abnormalities and highlights the importance of a high degree of clinical suspicion and consideration of atypical presentations of an anomalous uterus, especially if medical treatment fails.