Learning objectives
The aim of this paper is to describe radiologic findings in Herlyn-Werner-Wunderlich (HWW) syndrome.
Background
Definition: Herlyn-Werner-Wunderlich (HWW) syndrome,
also known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) is a rare form of uterovaginal duplication,
with three characteristic anomalies namely,
didelphys uterus,
unilateral obstructed hemivagina and ipsilateral renal agenesis [1].
It was initially described in 1971 by Herlyn and Werner,
then in 1976,
Wunderlich described an association of right renal aplasia with a bicornuate uterus and simple vagina in the presence of an isolated hematocervix [2].
High index of suspicion of HWW syndrome is required in patients with Mullerian...
Findings and procedure details
Three patients were identified with HWW syndrome during period of observation from July until December 2016.
The clinical data of these patients was collected from both medical records and history taking.
Radiological features on abdominal CT,
Ultrasonography,
and MRI were demonstrated with simple description.
Abdominal US examination was performed with curve probe type.
Abdominal CT was performed on a 128 slice CT scanner.
Abdominal MRI examination was performed on a 1.5 Tesla MRI scanner.
Images acquisition done on multiple planes with T1-weighted (TR 631 ms;...
Conclusion
Herlyn-Werner-Wunderlich syndrome is very rare and its non specific symptoms or findings upon physical examination may result in delay of diagnosis,
though diagnosis simply can be made by imaging modalities.
Early diagnosis and treatment will relieve acute symptoms also preserve fertility.
Abdominal US is very useful in detecting mullerian duct anomaly,
whereas abdominal MRI is the most accurate tools for diagnosis of HWW syndrome.
A patient with single kidney without history of nephrectomy should raise suspicion of urogenital malformation,
especially HWW Syndrome.
Personal information
Contact details:
Dr.
Lies Mardiyana
Women’s Imaging Section.
Department of Radiology,
Dr.Soetomo General Hospital,
Medical Faculty Airlangga University,
Surabaya,
Indonesia.
Email:
[email protected]
Dr.
Fransisca Rika Andriani
Resident in training.
Department of Radiology,
Dr.Soetomo General Hospital,
Medical Faculty Airlangga University,
Surabaya,
Indonesia.
Email:
[email protected]
Dr.
Dina Heri Susanti
Resident in training.
Department of Radiology,
Dr.Soetomo General Hospital,
Medical Faculty Airlangga University,
Surabaya,
Indonesia.
Email:
[email protected]
References
1. Mehra S,
Chamaria K,
Garga UC,
Kataria A,
Ahuja A.
Imaging Diagnosis of Herlyn-Werner-Wunderlich Syndrome-An Extremely Rare Urogenital Anomaly.
Journal of clinical and diagnostic research: JCDR.
2015 May;9(5):TD06.
2. Zhu L,
Chen N,
Tong JL,
Wang W,
Zhang L,
Lang JH.
New classification of herlyn-werner-wunderlich syndrome.
Chinese medical journal.
2015 Jan 20;128(2):222.
3.
Ahmad Z,
Goyal A,
Das CJ,
Deka D,
Sharma R.
Herlyn–Werner–Wunderlich syndrome presenting with infertility: Role of MRI in diagnosis.
The Indian journal of radiology & imaging.
2013 Jul;23(3):243.
4.
M...