Herlyn Werner Wunderlich Syndrome Diagnosed Through Pelvic Abscess

Introduction It is hard to diagnose Mullerian Anomalies since they are frequently asymptomatic It was seen 24% of women in reproduction age These patients in general refer to the hospital with stomach pain after menarche together with dysmenorrhea or amenorrhea

Herlyn Werner Wunderlich Syndrome is very rare case seen together with uterus didelphis, ipsilateral renal agenesis, and blind hemivagina Difficulty of diagnosis would result even to abscess instances occur in abdomen following hematocolpos

Case A 17 years old patient admitted to the hospital with stomach pain Her menstruations started at age of 12 with regular periods She was experiencing pain during her periods for last 2 years

We have observed tuboovarian abscess on left adnexal region at her abdominal ultrasonography At abdominal magnetic resonance, we have monitored 13 cm right adnexa based tubooveian abscess and 6 cm left adnexa based abscess

In addition, we did not observe left kidney during uterus didelphys In her pelvic examination, her vaginal length was normal Antibiotic treatment was began as her CRP value was 19 and we have planned the operation

During the operation, we have observed that bowel attached to the back of uterus After separation, we have observed right over and tuba were normal We have monitored 12 cm left adnexa based cist

We have cleaned abscess material in it We have not observed left over and tuba We have taken out cist on left adnexa completely We have put dren and closed the abdomen Later, we have performed vaginal examination

We have observed vaginal cavity containing puss on vaginal front wall, which was obliterated and separated from transvers septum We have extracted tissue between two vaginas We have observed two cervix during examination

Result To examine patients with ultrasonography is important to make early diagnosis and to design the treatment accordingly