title: Partial Cervical Agenesis and Complete Vaginal Atresia.
abstract: BACKGROUND
  The objective of this study was to report 2 cases of the combined congenital anomalies of complete vaginal atresia and partial cervical agenesis, and highlight the limitations of magnetic resonance imaging for definitive initial diagnosis, and consequently the importance of early definitive management, to avoid life-threatening sepsis. Herein we provide a retrospective case audit of two patients with congenital abnormalities between 2005 and 2013 who were treated in a quaternary statewide pediatric and adolescent gynecology center.
  
  
  METHODS
  Two patients with the combined congenital anomalies of complete vaginal agenesis and partial cervical agenesis highlight the difficulties encountered with the limitations of magnetic resonance imaging in accuracy of diagnosis, as well as development of life-threatening sepsis that requires hysterectomy. Both patients were initially imaged as having distended endometrial cavities and cervical canals with what was thought to be an obstructive upper vaginal septum and absent lower vagina. Both required initial neovagina creation, however the cervices were never clinically or surgically visualized.
  
  
  CONCLUSIONS
  Partial cervical agenesis is a relatively rare form of Müllerian abnormality which, if not diagnosed and definitively treated early, can have significant morbidity and mortality. Although magnetic resonance imaging is the diagnostic imaging gold standard for Müllerian abnormalities, it is important to recognize the limitations of this modality, the potential sequelae of these limitations, and to appreciate the importance of early accurate diagnosis and treatment of this condition. Importantly, if the imaging diagnosis does not completely correlate with the clinical and surgical findings, then a high suspicion of complete or partial cervical agenesis is prudent, because the consequences of nondefinitive early treatment can be life-threatening and potentially fatal.
authors.affiliation: Statewide Paediatric and Adolescent Gynaecology Service and Obstetric Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; University of Queensland, School of Medicine, Brisbane, Queensland, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kimble
authors.affiliation: Obstetrics and Gynaecology, Logan Hospital, Brisbane, Queensland, Australia. Electronic address: genevievemolloy@hotmail.com.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Molloy
authors.affiliation: Department of Medical Imaging, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Sutton
mesh_terms: D015746:Abdominal Pain / Q000151:congenital / Q000601:surgery; D000293:Adolescent; D002584:Cervix Uteri / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery; D014623:Vaginal Diseases / Q000151:congenital* / Q000601:surgery
keywords: Cervical agenesis; Müllerian abnormality; Vaginal atresia