Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis Syndrome in Adulthood: A Diagnostic Challenge.

Alexandros Loukas Grammatis, Ajibade F, Warakaulle D, Dada T
Diagnostics (Basel, Switzerland) · 2023 · doi:10.3390/diagnostics13213377 · PMID:37958273 · PMC10649003
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This case report details the diagnostic challenges and successful surgical management of a young adult woman with obstructed hemi-vagina with ipsilateral renal agenesis syndrome presenting as recurrent pelvic inflammatory disease symptoms.

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This case report describes an adult patient presenting with obstructed hemi-vagina and ipsilateral renal agenesis, a rare congenital anomaly that poses significant diagnostic challenges. The authors highlight the importance of recognizing this syndrome in adulthood to prevent misdiagnosis and ensure appropriate management of the associated reproductive tract obstruction. Clinical evaluation and imaging were utilized to confirm the anatomical abnormalities and rule out other potential causes for the patient's symptoms. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

A patient in her early 20s presented with constant and progressive lower abdominal and back pain, mainly on the right side of the abdomen, purulent vaginal discharge and pyrexia. A radiological assessment revealed a possible tubo-ovarian abscess and the incidental diagnosis of ipsilateral renal agenesis. The patient was treated for pelvic inflammatory disease (PID); however, after antibiotic administration and since the symptoms did not resolve, an abdominal MRI was requested, which revealed uterus didelphys with two cervices, an obstructed haemivagina and evidence of haematocolpos. The diagnosis of Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome was confirmed, and the patient underwent the excision of the vaginal septum, the drainage of the haematopyocolpos and the laparoscopic drainage of the tubo-ovarian abscess. She achieved a good recovery.
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Ack

The authors thank the patient for their cooperation.

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All data generated or analysed during this study are included in the article.

Author

A.L.G. wrote the initial draft and performed the literature review. F.A. conceptualised the case report and made editorial amendments. D.W. reviewed all images and helped with the figure legends. T.D. supervised the project and made substantial editorial amendments. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

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Written informed consent has been obtained from the patient to publish this paper.

Conflicts

The authors declare no conflict of interest.

Associated Data

All data generated or analysed during this study are included in the article.

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