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2026, Number 2

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Cir Gen 2026; 48 (2)

When pain leads to surgery: Wünderlich syndrome

Hernández-García EF, García NLM, Portillo HMC
Full text How to cite this article 10.35366/123464

DOI

DOI: 10.35366/123464
URL: https://dx.doi.org/10.35366/123464

Language: Spanish
References: 5
Page: 96-99
PDF size: 957.91 Kb.


Key words:

Wünderlich syndrome, surgical treatment, congenital malformation.

ABSTRACT

Wünderlich syndrome is a congenital Müllerian malformation of the female genital tract secondary to incomplete development and/or failure of fusion of the Müllerian ducts, or to incomplete resorption of the uterine septum. Its reported incidence ranges from 0.5 to 5% of live female births. It is characterized by the triad of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A high index of suspicion for Wünderlich syndrome should be maintained in patients presenting with characteristic pelvic pain following menarche, generally secondary to hematocolpos caused by a vertical obstructing vaginal septum, which may manifest as acute abdominal pain and lead to unnecessary exploratory laparotomy. We report the case of a patient with no significant pathological history who presented with severe pelvic pain accompanied by leukocytosis and underwent exploratory laparotomy due to a high suspicion of intra-abdominal abscess; however, no abdominal pathology was identified, and only uterus didelphys was observed. Subsequently, vaginal examination revealed obstruction of the right cervix, and cervical dilation with drainage of pyometra was performed, resulting in satisfactory resolution of the clinical condition.


REFERENCES

  1. Ahualli J, Méndez-Uriburu L, Ravera ML, Méndez-Uriburu J, Raimondo MA. Síndrome de Herlyn-Werner-Wünderlich: a propósito de un caso. Rev Argent Radiol. 2011; 75: 203-206.

  2. Stoisa D, Armas D, Lucena ME, Staffieri R, Villavicencio RL. Síndrome de Wünderlich. Útero didelfo, hemivagina ciega y agenesia renal homolateral. Puesta al día. Anuario fundación Villavicencio. 2005; 13: 177-181.

  3. Di Benedetto V, Bailez M. Síndrome de Wünderlich: útero didelfo con hemivagina ciega y agenesia renal homolateral. Rev Cir Infant. 2001; 2: 222-225.

  4. Hayashi S, Ono M, Sagisaka M, Mimura T, Kojima J, Ono M, et al. A case of Herlyn-Werner-Wunderlich syndrome with exacerbation of hematometra after adnexectomy. Asian J Endosc Surg. 2024; 17: e13361. doi: 10.1111/ases.13361.

  5. Zurawin RK, Dietrich JE, Heard MJ, Edwards CL. Didelphic uterus and obstructed hemivagina with renal agenesis: case report and review of the literature. J Pediatr Adolesc Gynecol. 2004; 17: 137-141.




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C?MO CITAR (Vancouver)

Cir Gen. 2026;48