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Bloomfield V, Kives S, Allen L. Case Report: Neonate Presenting with Acute Kidney Injury Secondary to Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome: Long-Term Follow-Up. J Pediatr Adolesc Gynecol 2024; 37:213-216. [PMID: 37871844 DOI: 10.1016/j.jpag.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/23/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome describes a spectrum of Mullerian anomalies characterized by uterine didelphys, unilateral obstructed hemivagina, and ipsilateral renal anomalies. We report the case of a neonatal complication secondary to OHVIRA syndrome with long-term follow-up, adding to the collective understanding of this syndrome. CASE SUMMARY We present a 22-day-old female with an acute kidney injury secondary to post-renal obstruction from a large hydrometrocolpos. Multidisciplinary care facilitated timely diagnosis of OHVIRA syndrome and temporizing operative management. The patient was followed serially into her adolescence and ultimately underwent definitive excision of her vaginal septum. DISCUSSION OHVIRA syndrome encompasses a broad spectrum of anatomical variation with different considerations in prepubertal and postpubertal patients. Multidisciplinary care allows for timely diagnosis and clinical decision-making within this complex patient population.
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Affiliation(s)
- Valerie Bloomfield
- Department of Pediatric and Adolescent Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Sari Kives
- Department of Pediatric and Adolescent Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Allen
- Department of Pediatric and Adolescent Gynecology, Hospital for Sick Children, Toronto, Ontario, Canada
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Arab W, Abdelkhalek Y, Zoghbi A, Atallah D. Late diagnosis of Herlyn-Werner-Wunderlich syndrome: Is there a need for an early screening? Congenit Anom (Kyoto) 2023; 63:219-220. [PMID: 37736683 DOI: 10.1111/cga.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/02/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Wissam Arab
- Obstetrics and Gynecology Department, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Yara Abdelkhalek
- Obstetrics and Gynecology Department, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Antoine Zoghbi
- Emergency Department, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - David Atallah
- Obstetrics and Gynecology Department, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
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Borges AL, Sanha N, Pereira H, Martins A, Costa C. Herlyn-Werner-Wunderlich syndrome also known as obstructed hemivagina and ipsilateral renal anomaly: A case report and a comprehensive review of literature. Radiol Case Rep 2023; 18:2771-2784. [PMID: 37388267 PMCID: PMC10300495 DOI: 10.1016/j.radcr.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/05/2023] [Indexed: 07/01/2023] Open
Abstract
Herlyn-Werner-Wunderlich syndrome, also known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), is a Müllerian duct anomaly. It is a rare clinical condition consisting of a duplicated uterus with an oblique vaginal septum that causes partial genital tract outflow obstruction. A urinary tract anomaly, most commonly renal agenesis, is usually present on the obstructed side. The diagnosis of genital tract outflow obstruction is often delayed due to the normal functioning of the unaffected side. The most frequent complications are dysmenorrhea, chronic pelvic pain, infection, infertility and endometriosis. This report describes a 17-year-old G0P0 patient with a history of severe dysmenorrhea and left-sided renal agenesis, who was admitted for complaints of foul vaginal discharge over the past 3 months that was unsuccessfully treated with antibiotics. Transrectal ultrasound revealed the presence of 2 separate hemicavities on transverse and longitudinal views. A cystic lesion with ground-glass opacities was detected between the bladder and a normal-appearing cervix, which was determined to be hematocolpos. The diagnosis of OHVIRA was made. This case highlights the importance of excluding a Müllerian anomaly in the presence of renal system abnormalities. Being aware of the type of anomalies, combinations and variants is crucial to determine the diagnosis and the best surgical approach. Ultrasound was an invaluable imaging exam to determine the type of anomaly and its complexity. Awareness of this syndrome and its variants will prevent misdiagnosis and will help to define the appropriate treatment for these patients.
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Affiliation(s)
- André Luís Borges
- Obstetrics and Gynecology Department, Hospital de São Francisco Xavier-Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto Duque, Edificio 2 Piso 3, Lisboa, 1449-005, Portugal
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal
| | - Nhalim Sanha
- Obstetrics and Gynecology Department, Hospital de São Francisco Xavier-Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto Duque, Edificio 2 Piso 3, Lisboa, 1449-005, Portugal
| | - Helena Pereira
- Obstetrics and Gynecology Department, Hospital de São Francisco Xavier-Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto Duque, Edificio 2 Piso 3, Lisboa, 1449-005, Portugal
| | - Ana Martins
- Obstetrics and Gynecology Department, Hospital de São Francisco Xavier-Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto Duque, Edificio 2 Piso 3, Lisboa, 1449-005, Portugal
| | - Cristina Costa
- Obstetrics and Gynecology Department, Hospital de São Francisco Xavier-Centro Hospitalar de Lisboa Ocidental, Estrada Forte do Alto Duque, Edificio 2 Piso 3, Lisboa, 1449-005, Portugal
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Niu G, Zhai Y, Meng L, Zhao L, Liu N, Xing X, Wen X, Chen J. Laparoscopy combined with transvaginal surgery for Herlyn-Werner-Wunderlich syndrome: A case report. Medicine (Baltimore) 2022; 101:e32264. [PMID: 36626531 PMCID: PMC9750648 DOI: 10.1097/md.0000000000032264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital Mullerian duct anomaly disease that is characterized by a triad of symptoms, didelphys uterus, blind hemivagina, and ipsilateral renal agenesis. Herein, we reported a case from China. CASE PRESENTATION An 11-year-old patient presented to our hospital with lower abdominal pain and frequent urination. Computed tomography and magnetic resonance imaging revealed hematocolpos, uterine hemorrhage, didelphys uterus, and renal agenesis on the right side. Thus, the patient was diagnosed with HWW syndrome. Laparoscopic combined with transvaginal surgery to remove the vaginal septum, the symptoms of the lesion disappeared after the blood was discharged. CONCLUSION Abnormal urination and other symptoms should be carefully examined in adolescent girls with abdominal pain not menarche, since they may be related to reproductive organ development disorders and other diseases. We recommend laparoscopy combined with transvaginal surgery to remove the oblique septum in HWW syndrome, which is rarely reported.
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Affiliation(s)
- Gaoli Niu
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Yanhong Zhai
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
- *Correspondence: Yanhong Zhai, Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, 454000, China (e-mail: )
| | - Luhong Meng
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Lingli Zhao
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Nannan Liu
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Xuejiao Xing
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Xin Wen
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
| | - Jingjing Chen
- Department of Gynecologic Oncology, The First Affiliated Hospital of Henan Polytechnic University (The Second People’s Hospital of Jiaozuo), Jiaozuo, China
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Degheili JA, Khaled M, Chouikh T, Aoun B. Pyocolpos: A rare cause of recurrent abdominal pain - Always insist on a thorough physical examination. Radiol Case Rep 2022; 17:1678-1681. [PMID: 35342495 PMCID: PMC8942785 DOI: 10.1016/j.radcr.2022.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 11/30/2022] Open
Abstract
Thorough physical examination is a must for proper diagnosis of medical diseases and to elucidate all physical findings. Abdominal pain is a very common presentation to Emergency Department, compromising 5%-10% of all visits, and around a quarter are discharged with no particular diagnosis. Pyocolpos is one of those presentations that requires a thorough physical examination, including that of the external genitalia. A 3-year-old girl presented with recurrent history of abdominal pain and a recent history of fever with acute abdomen picture-like presentation, with difficulty voiding over the past few days. She was previously assessed for recurrent abdominal pain, without any identifiable etiology. Upon inspection for indwelling catheter insertion, absence of the vaginal introitus was noted with a bulging mass and an imperforate hymen. Pyocolpos was diagnosed and drained following hymenotomy. Pyocolpos is a rare complication of hydrocolpos. Enlarged vagina causes extrinsic compression to nearby structures, such as the bladder trigone and ureters, causing hydronephrosis, hydroureter, and other sequel including acute kidney injury and urosepsis. An imperforate hymen must be considered in the differential for chronic and recurrent abdominal pain, and can be easily identified by a thorough physical examination, including that of the external genitalia, which is a must in today's every medical practice.
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Affiliation(s)
- Jad A. Degheili
- Division of Pediatric Urology, Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ontario, Canada
| | - Mohamed Khaled
- Department of Pediatrics and Neonatology, Intercommunal Hospital Group Le Raincy Montfermeil, Montfermeil, France
| | - Taieb Chouikh
- Department of visceral, vascular and urological surgery, Intercommunal Hospital Group Le Raincy Montfermeil, Montfermeil, France
| | - Bilal Aoun
- Department of Pediatrics and Neonatology, Intercommunal Hospital Group Le Raincy Montfermeil, Montfermeil, France
- Division of Pediatric Nephrology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Corresponding author.
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Gutiérrez-Montufar OO, Zambrano-Moncayo CP, Otálora-Gallego MC, Meneses-Parra AL, Díaz-Yamal I. Síndrome de Herlyn-Werner-Wunderlich: reporte de caso y revisión de la literatura. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGÍA 2021; 72:407-422. [PMID: 35134287 PMCID: PMC8833243 DOI: 10.18597/rcog.3699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022]
Abstract
Objetivo: Presentar un reporte de caso de síndrome de Herlyn Werner Wunderlich (SHWW) y hacer una revisión de la literatura para determinar los hallazgos clínicos e imagenológicos en estas pacientes. Materiales y métodos: Se presenta el caso de una mujer de 16 años que consultó, en un hospital de las fuerzas militares en Bogotá, por dolor pélvico recurrente, su diagnostico final fue SHWW. Se realizó una búsqueda sistemática de la literatura en las diferentes bases de datos, revisiones sistemáticas, cohortes, series de casos y reportes de casos en pacientes con diagnóstico de SHWW en cualquier edad, se obtuvo información sobre las características de presentación clínica, y las tecnologías diagnósticas más frecuentemente utilizadas. Se hace resumen narrativo de los hallazgos. Resultados: Se incluyeron 77 publicaciones, un total de 676 pacientes. Los síntomas más frecuentes fueron dismenorrea (63,9 %), seguido de dolor pélvico (35,2%). Las tecnologías diagnósticas más utilizadas fueron el ultrasonido pélvico en un 92,1% y la resonancia magnética nuclear en un 74,6% de los casos. La histeroscopia y laparoscopia son poco utilizados en el diagnóstico. Conclusión: El SHWW es una entidad poco frecuente, debe hacer parte del estudio complementario de la agenesia renal del paciente pediátrico y del diagnóstico diferencial de la dismenorrea primaria en pacientes en la adolescencia. Se requiere evaluar con estudios de cohorte más grandes la utilidad de la histeroscopia en estas pacientes.
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Affiliation(s)
| | | | | | | | - Ivonne Díaz-Yamal
- Docente de la Universidad Militar Nueva Granada, Bogotá (Colombia)..
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McCarson KL, Walters CA, Cantu RM. Unusual Cause of Sepsis in a 10-Year-Old Female. Clin Pediatr (Phila) 2020; 59:1036-1039. [PMID: 32475152 DOI: 10.1177/0009922820927020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Rebecca M Cantu
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Zhang J, Xu S, Yang L, Songhong Y. MRI image features and differential diagnoses of Herlyn-Werner-Wunderlich syndrome. Gynecol Endocrinol 2020; 36:484-488. [PMID: 31657238 DOI: 10.1080/09513590.2019.1680623] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
This study aims to explore how Herlyn-Werner-Wunderlich Syndrome (HWWS) manifests in diagnostic images and analyze the imaging specifications and differential diagnoses thus improving the understanding of the disease. The preoperative magnetic resonance imaging (MRI) findings and clinical data of 19 patients with HWWS were retrospectively analyzed, taking the intraoperative findings and postoperative pathological results of laparoscopic or hysteroscopy surgery as the diagnostic criteria. In this study, all the 19 patients underwent laparoscopic or hysteroscopic excision of vaginal oblique septum, and the preoperative MRI diagnosis of HWSS was consistent with the clinical postoperative diagnosis, with a diagnosis coincidence rate of 19/19 (100%). According to the classification of vaginal oblique septum syndrome, 16 cases were vaginal oblique septum type I and 3 cases were vaginal oblique septum type II. MRI showed a double uterus and double cervix, blood accumulation and dilatation of the vagina connected with the cervix of the affected side, T1WI showed high signal intensity and T2WI showed low or mixed signal intensity. MRI coronal view of 19 patients clearly showed ipsilateral renal absence with obstruction, including 5 cases on the left and 14 cases on the right. Other pelvic complications included: 1 patient with cervical dysplasia and the absence of right kidney and ureter, 3 patients with right ovarian endometriosis cyst, 1 patient with complicated with adenomyosis, 1 patient with right ovarian follicular cyst, 1 patient with right ovarian fallopian tube and pelvic abscess, and 1 patient with right ovarian hematoma. The MRI image of HWWS has its own features and MRI can more accurately evaluate type and related complications of HWWS, therefore it can be used as the best and effective examination method for preoperative imaging evaluation, thus better providing help for clinical comprehensive preoperative evaluation and guidance of surgery.
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Affiliation(s)
- Jinlong Zhang
- Department of Respiratory Medicine, The 940th hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou, China
| | - Shengfang Xu
- Department of Medical Imaging Center, Gansu Provincial Maternal and Child Care Hospital, Lanzhou, China
| | - Lei Yang
- Functional Examination Department, Gansu Provincial Maternal and Child Care Hospital, Lanzhou, China
| | - Yue Songhong
- Nuclear Magnetic Resonance Chamber, Lanzhou University Second Hospital, Lanzhou, China
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Fascilla FD, Olivieri C, Cannone R, De Palma D, Manosperta F, Costantino AS, Carugno J, Vicino M, Cicinelli E, Bettocchi S. In-office Hysteroscopic Treatment of Herlyn-Werner-Wunderlich Syndrome: A Case Series. J Minim Invasive Gynecol 2020; 27:1640-1645. [PMID: 32320799 DOI: 10.1016/j.jmig.2020.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/26/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
Herlyn-Werner-Wunderlich syndrome (HWWs) is a rare congenital malformation of the female urogenital track characterized by a triad consisting of didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. We report 5 consecutive cases of patients diagnosed with HWWs treated in our center. Imaging studies with 2-dimensional/3-dimensional ultrasound and abdominopelvic magnetic resonance imaging were obtained to confirm the diagnosis. The treatment consisted of a 1-step surgical in-office hysteroscopic incision of the vaginal septum using 5 Fr hysteroscopic bipolar electrodes. At the follow-up visit, between 1 and 2 months after the initial procedure, the patients underwent a diagnostic vaginoscopy with excision of exceeding vaginal tissue if needed, performed with a vaginal hysteroscopic approach. In-office hysteroscopic treatment of patients diagnosed with HWWs is a safe and effective, minimally invasive treatment modality that provides symptomatic relief and preserves fertility, avoiding the cost and risks of the use of general anesthesia in an operating room setting. We recommend shifting the management of this challenging condition to the office setting.
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Affiliation(s)
- Fabiana Divina Fascilla
- Unit of Obstetrics and Gynecology, Di Venere Hospital, Bari Local Health Authority (Drs. Fascilla and Vicino)
| | - Claudiana Olivieri
- II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli)
| | - Rossella Cannone
- II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli)
| | - Domenico De Palma
- II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli)
| | - Francesco Manosperta
- Student at Medical School of the Faculty of Medicine, University "Aldo Moro" of Bari, Italy (Dr. Manosperta)
| | - Alfredo Sigfrido Costantino
- II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli)
| | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Sciences Department, Minimally Invasive Gynecology Unit, University of Miami, Miller School of Medicine, Miami, Florida (Dr. Carugno)
| | - Mario Vicino
- Unit of Obstetrics and Gynecology, Di Venere Hospital, Bari Local Health Authority (Drs. Fascilla and Vicino)
| | - Ettore Cicinelli
- II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli)
| | - Stefano Bettocchi
- Inter-Departmental Project Unit of "Minimal-Invasive Gynecological Surgery," Policlinico of Bari (Dr. Bettocchi) University of Bari Aldo Moro, Bari, Italy.
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Ghasemi M, Esmailzadeh A. An unusual appearance of the post-pubertal Herlyn-Werner-Wunderlich syndrome with acute abdominal pain: A case report. Int J Reprod Biomed 2020; 17:851-856. [PMID: 31911967 PMCID: PMC6906875 DOI: 10.18502/ijrm.v17i10.5498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/15/2019] [Accepted: 07/10/2019] [Indexed: 11/24/2022] Open
Abstract
Background Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital urogenital defect. It is detected by unilateral low vaginal obstruction, uterus didelphys, and ipsilateral kidney agenesis. It usually becomes apparent with pain, dysmenorrhea, and presence of a vaginal or pelvic mass. Purulent vaginal discharge may also happen rarely because of infective complications of the obstructed hemivagina. In this report, we describe a post-pubertal case with acute abdominal pain. Case The patient was a 13-yr-old girl who was referred to us with acute abdominal pain one year after the onset of her menarche. In the pelvic examination, we detected hematocolpos. Abdominopelvic-computed tomography scan confirmed the presence of mullerian duct anomalies with uterus didelphys. This case of HWW syndrome along with pyocolpus was managed by vaginal septum resection, drainage of pus, and salpingectomy. Conclusion The symptoms of HWW syndrome should be monitored in early puberty to prevent more complications.
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Affiliation(s)
- Marzieh Ghasemi
- Department of Obstetrics and Gynecology, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Arezoo Esmailzadeh
- Department of Obstetrics and Gynecology, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Sleiman Z, Zreik T, Bitar R, Sheaib R, Al Bederi A, Tanos V. Uncommon presentations of an uncommon entity: OHVIRA syndrome with hematosalpinx and pyocolpos. Facts Views Vis Obgyn 2017; 9:167-170. [PMID: 29479403 PMCID: PMC5819326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Müllerian malformations result from defective fusion of the Müllerian ducts during development of the female reproductive system. The least common form of these malformations is Herlyn-Werner-Wunderlich syndrome characterized by obstructed hemivagina and ipsilateral renal anomaly (OHVIRA). The most common presentation of this syndrome is a mass secondary to hematocolpos, pain, and dysmenorrhea. Clinical diagnosis is very challenging and requires imaging studies in which ultrasound and MRI play an essential role in the diagnosis, classification and treatment plan. We report two cases of this syndrome, featuring two very rare clinical presentations: hematosalpinx and pyocolpos. The clinical course of the pathology is not standard and each patient is treated accordingly.
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Affiliation(s)
- Z Sleiman
- Lebanese American University, Department of Obstetrics and Gynecology, Beirut, Lebanon
| | - T Zreik
- Lebanese American University, Department of Obstetrics and Gynecology, Beirut, Lebanon
| | - R Bitar
- Lebanese American University, Department of Obstetrics and Gynecology, Beirut, Lebanon
| | - R Sheaib
- Lebanese American University, Department of Obstetrics and Gynecology, Beirut, Lebanon
| | | | - V Tanos
- St. George’s Medical School, Nicosia University, Nicosia, Cyprus
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