Objectives: Endometrial pathologies are common ultrasound findings in group of peri and postmenopausal women and are an indication for further diagnostics including biopsy, curettage, hysteroscopy. This study assessed whether a new elastography application with quantification possibility can differentiate normal and abnormal endometrium and to be a helpful tool to establish further management. Methods: The study included a group of 47 patients with endometrial thickness more than 5 mm. Elastographic images of the uterus were achived in all patient, due to pressure applied by operator of transvaginal probe. Mid-saggital view of endometrium was delineated and assessed, according to EITA scale and with the use of elastography index (EI). Subsequently pathological analysis was performed. Correlation between elastography indices, presented in numbers and pathologic results was analyzed. Results: Pathologies of endometrium (7 cases of carcinoma, 12 polyps, 5 hyperplasia) had higher elastography index -above 3. 22 out of 23 patients with normal and atrophic endometrium had EI less than 3. The values of EI for endometrial pathologies were in range from 3 to 8, the highest values were in hyperlasia and cancer. The corellation was significant, p < 0,0001.We did not find any changes in elastograms and EI, depending on the amount of pressure applied during examination. Conclusions: Quantification elastography proved to be helpful in differentiation between normal and pathological endometrium. Elastography could be an additional tool in planning further patient management. These results are in compliance with our previous study performed on different equipment.Supporting information can be found in the online version of this abstract AVM of the myometrium considered a rare entity. It is believed that acquired uterine AVM is fed from a solitary vessel while congenital lesions have many feeding vessels. We show by Doppler that some acquired uterine AVM alsow can be fed by multiple feeding vessel.Case presentations: Case 1: A 32 years old patient, G1P1, 2nd infertility.History of laparoscopic endometrioma cystectomy followed by IVF treatment, pregnancy and NSVD.repeated laparoscopic cystectomy for repeated giant endometrioma followed by two IVF reatment. Referred for routine Ultrasound evaluation 8 weeks post IVF treatment.The US revealed posterior wall hypo-echogenic mass with two jets flow. Color Doppler Ultrasound established the diagnosis of posterior wall AVM. The patient was treated with one selective embolization evaluated post treatment by Doppler Ultrasound. Case 2: A 37 years old patient, G3P2CS2A1, with delayed post abortion hemorrhage. Six weeks post D&C she presented to the emergency room with vaginal hemorrhage. Doppler ultrasound imaging established the diagnosis of an anterior wall uterine AVM.The patient was treated with two consecutive selective embolization evaluated by Doppler US. Conclusion: AVM of the uterus should be suspected in women presenting with vaginal hemorrhage, following abortion or delivery but...

Uterine developmental abnormalities can cause both obstetric and gynaecological complications. Non-functioning rudimentary uterine horn is a rare cause of dysmenorrhoea which usually starts after menarche. Cases with lateral/inferior arrangement of blood supply to the functioning rudimentary horn and lapascopic removal have been described in literature. Ours is a unique case of non-functioning rudimentary horn with an unusual medial arrangement of vasculature successfully treated by laparoscopic excision. We also present a brief review of the literature. The patient presented with irretractable dysmenorrhoea despite hormonal manipulation and analgesics. Following the diagnosis using laparoscopy and hysteroscopy and MRI, the left sided non-communicating rudimentary horn with inactive endometrium was removed laparoscopically. Her symptoms were resolved and this was followed by successful pregnancies. Diagnosis of rudimentary horn with inactive endometrium is difficult. Ultrasound is unreliable. MRI, 3D CT scan and 3D ultrasound are gaining popularity. Accurate, prior identification of the type using laparoscopy and hysteroscopy if necessary is essential. This helps in surgical planning. The laparoscopic approach is increasingly being used to resect these horns due to its safety and merits.

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