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Kim, Park, Ku, Kim, Choi, Kim, and Moon: An unusual presentation of obstructed hemivagina and ipsilateral renal anomaly syndrome: A case report
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(12): 820-824.

Published online: 15 December 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.12.820

An unusual presentation of obstructed hemivagina and ipsilateral renal anomaly syndrome: A case report

Woo-Oh Kim, MD1, Kyung Eui Park, MD1, Seung-Yup Ku, MD, PhD1, 2, Seok Hyun Kim, MD, PhD1, 2, Young Min Choi, MD, PhD1, 2, Jung Gu Kim, MD, PhD1, Shin Yong Moon, MD, PhD1, 2

1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

2Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University, Seoul, Korea.

Corresponding author: Seung-Yup Ku, MD, PhD. Department of Obstetrics and Gynecology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-1971, Fax: +82-2-762-3599, jyhsyk@snu.ac.kr

Received 3 May 2011       Accepted 8 August 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Most patients with syndrome of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) were presented with dysmenorrhea, pelvic mass and hematocolpos. These common symptoms of OHVIRA syndrome were aggravated soon after the menarche. Early diagnosis is important to relieve the symptom, to prevent injury of genital tract and to preserve fertility. We have experienced an unusual presentation of OHVIRA syndrome, which were presented with vaginal spotting and diagnosed at age 24. Therefore, we present it with a review of the literature.

Keywords: Uterus didelphys, Obstructed hemivagina, Renal agenesis, Müllerian anomalies

Figures and Tables

Fig. 1
Transvaginal sonographic findings. (A) Uterine didelphys on coronal view. (B) Hematocolpos on sagittal view.
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Fig. 2
The left upper vagina was dilated and filled with hematoma which was seen as high signal intensity on T2 weighted magnetic resonance imaging. This finding caused by vaginal atresia was consistent with hematocolpos. The annotated tubular structure arising from left upper side of affected vagina was presumed remnant left distal ureter opened to the vagina.
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Fig. 3
The left upper vagina was dilated and filled with hematoma which was seen as high signal intensity on T2 weighted magnetic resonance imaging. This finding caused by vaginal atresia was consistent with hematocolpos. The annotated tubular structure arising from left upper side of affected vagina was presumed remnant left distal ureter opened to the vagina.
kjog-54-820-g003
Fig. 4
Post-instillation images of saline infusion sonohysterography. (A) Endometrial cavity of right uterus was dilated normally. (B) But left side was not. There is no evidence of communication between both side of uterine cavity.
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Fig. 5
Laparoscopic finding. There were normal ovaries and tubes arising from each side of uterine cornus. Left lower side of uterine posterior wall was hyperemic and bulged due to hematocolpos. There was a small endometriotic spot on the affected peritoneal surface.
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References

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