Herlyn-Werner-Wunderlich syndrome in a young female presenting with dysmenorrhea: A case report

Abstract

Herlyn-Werner-Wunderlich (HWW) syndrome, popularly known by acronym of obstructed hemivagina with ipsilateral renal agenesis (OHVIRA) is a rare Müllerian and Wolffian duct anomaly. The syndrome is classically described as triad of uterine didelphy, obstructed hemivagina, and ipsilateral renal agenesis. The symptoms are seen after menarche. Clinically, the patients present with dysmenorrhea, palpable paravaginal mass, increased frequency of micturition heaviness in pelvis and sometimes with infertility after marriage. Imaging is the cornerstone for diagnosis of the condition. Radiologists should screen for Müllerian duct anomaly if unilateral renal agenesis is detected and vice versa. Early diagnosis and surgical intervention help in prevention of complications like endometriosis, adhesions in lesser pelvis, infertility, pyosalpinx, abscess, and hematoma of cervix and vagina. We present a case of HWW syndrome in an adolescent female visiting the emergency department with complaint of dysmenorrhea. We diagnosed the case in ultrasonography (US) and confirmed in MRI.

Keywords

• Herlyn-Werner-Wunderlich (HWW)
• Müllerian duct
• Obstructed hemivagina with ipsilateral renal agenesis (OHVIRA)
• Pyosalpinx