HERLYN-WERNER-WUNDERLICH SYNDROME-ROLE OF IMAGING IN TIMELY AND CORRECT DIAGNOSIS

Hidayat Ullah, Atiq Ur Rehman Slehria, Rashid Mahmood, Jehan Akbar
In: Pakistan Armed Forces Medical Journal · 2021 · vol. 71(1) , pp. 364–66 · doi:10.51253/pafmj.v71i1.3740 · W3134679919
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-08-08 ⓘ

This case highlights that Herlyn-Werner-Wunderlich syndrome, characterized by uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis, can be diagnosed by CT after being missed on ultrasound.

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⚙ AI-generated deep summary by gpt-5.6-luna, 2026-08-12 · read from full text ⓘ

This case report describes Herlyn-Werner-Wunderlich syndrome (OHVIRA) in a young female with uterus didelphys, right-sided obstructed hemivagina and hematometrocolpos, and ipsilateral renal agenesis. Ultrasound failed to identify the condition, whereas plain CT of the abdomen and pelvis established the diagnosis; the authors emphasize considering the syndrome in patients with lower abdominal pain, a pelvic mass, unilateral renal agenesis, and an ipsilateral pelvic cystic lesion. The principal limitation was the diagnostic miss on initial ultrasound, while the report highlights that delayed recognition can lead to pyocolpos and retrograde blood spillage. Relevance to endometriosis: the paper identifies retrograde menstrual blood flow and consequent endometriosis as potential complications of untreated obstructed hemivagina, though its main focus is imaging-based diagnosis of Herlyn-Werner-Wunderlich syndrome.

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Abstract

We present this case of uterus didelphys with right sided haematometrocolpos due to obstructed hemivaginaand ipsilateral renal agenesis-Herlyn Werner Wunderlich syndrome. The condition was missed on ultrasoundand diagnosed on plain CT scan abdomen and pelvis. This syndrome should be kept in mind while dealing witha young female complaining of lower abdominal pain and a pelvic mass having unilateral renal agenesis and anipsilateral pelvic cystic lesion on ultrasound or other imaging modality. Timely diagnosis is important to avoidcomplications like pyocolpos and retrograde spilling of blood with consequent endometriosis. Imaging plays amajor role in a correct and timely diagnosis.
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HERLYN-WERNER-WUNDERLICH SYNDROME-ROLE OF IMAGING IN TIMELY AND CORRECT DIAGNOSIS DOI: https://doi.org/10.51253/pafmj.v71i1.3740Keywords: Herlyn Werner Wunderlich syndrome, OHVIRA, Renal agenesis, Uterus didelphys, Haematometrocolpos, Müllerian duct anomaliesAbstract We present this case of uterus didelphys with right sided haematometrocolpos due to obstructed hemivagina and ipsilateral renal agenesis-Herlyn Werner Wunderlich syndrome. The condition was missed on ultrasound and diagnosed on plain CT scan abdomen and pelvis. This syndrome should be kept in mind while dealing with a young female complaining of lower abdominal pain and a pelvic mass having unilateral renal agenesis and an ipsilateral pelvic cystic lesion on ultrasound or other imaging modality. Timely diagnosis is important to avoid complications like pyocolpos and retrograde spilling of blood with consequent endometriosis. Imaging plays a major role in a correct and timely diagnosis.

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endometriosis

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