2026, Number 2
When pain leads to surgery: Wünderlich syndrome
Hernández-García EF, García NLM, Portillo HMC
Full text
10.35366/123464
Language: Spanish
References: 5
Page: 96-99
PDF size: 957.91 Kb.
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 intraabdominal 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