Author(s)

Hayat Al-Jumah^1*, Rashida Sadiq¹, Noor Al-Muslem², Fathia E. Al-Jama³, Raghad Aljishi⁴, Salah Abohelaika⁵

¹Department of Obstetrics and Gynecology, Qatif Central Hosptial, Qatif, KSA.
²Department of Radiology, Qatif Central Hosptial, Qatif, KSA.
³King Fahad University Hospital, Private Health Services Centre, Khobar, KSA.
⁴Royal College of Surgeons, Dublin, Ireland.
⁵Clinical Pharmacology Department, Qatif Central Hosptial, Qatif, KSA.

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly characterized by triad of uterus didelphys, obstructed hemi vagina, and ipsilateral renal agenesis. The most common presentation is abdominal pain, dysmenorrhea, and abdominal mass secondary to hemi-hematometrocolpos. We report an emergency presentation of this syndrome during the pandemic of COVID-19 in Qatif Central Hospital, Saudi Arabia, April 2020. An 11-year-old Saudi girl presented to the emergency room with three months history of cyclical lower abdominal pain. The pain was progressive, continuous and not relieved by analgesics. Abdominal examination revealed a tender abdominal mass mainly in the left iliac fossa, Ultrasound evaluation showed two uterine bodies. The left uterus was distended with complex fluid. Pelvic MRI findings consistent with Herlyn-Werner-Wunderlich (HWW) syndrome were found with uterine didelphys and left sided hematometra resulting from obstructed hemi-vagina and ipsilateral agenesis of the left kidney. Resection of the vaginal septum and drainage of hematometra was done. The patient recovered with normal cyclical menstruation. Cyclical or continuous lower abdominal pain with or without amenorrhea is the usual presentation of HWW syndrome during adolescence. Diagnosis is made by ultrasonography and MRI. Early diagnosis and accurate management can provide pain relief, prevent future complications, and preserve fertility.

Herlyn-Werner-Wunderlich Syndrome, Obstructed Hemi-Vagina, Hematometrocolpos, Mullerian Anomaly, Vaginoplasty

Al-Jumah, H. , Sadiq, R. , Al-Muslem, N. , Al-Jama, F. , Aljishi, R. and Abohelaika, S. (2021) Herlyn-Werner-Wunderlich Syndrome Presenting with Abdominal Pain: A Case Report. Open Journal of Obstetrics and Gynecology, 11, 911-916. doi: 10.4236/ojog.2021.117085.