A case of Herlyn-Werner-Wunderlich syndrome with exacerbation of hematometra after adnexectomy.

A 27-year-old nulliparous woman presented with a feeling of fullness in the lower abdomen and abdominal pain. A left ovarian tumor, uterus didelphys, left renal agenesis, and left vaginal atresia were observed on imaging. The ovarian tumor was presumed to have caused the abdominal pain, and an abdominal left adnexectomy was performed. After 3 months, she reported severe lower abdominal pain during menstruation. Transvaginal ultrasonography revealed uterine enlargement. After 17 days, the patient presented with abdominal pain and fever. She was diagnosed with peritonitis due to infection and left uterine hematometra. Because she did not improve with antibiotic treatment, left laparoscopic hysterectomy was performed. Subsequently, she did not experience the lower abdominal pain. Appropriate diagnosis and treatment based on the morphology of the reproductive tract and symptoms must be considered in patients with Herlyn-Werner-Wunderlich syndrome. Treatment must permit the outflow of menstrual blood.

Hematometra y hematocervix en paciente postmenopáusica: reporte de caso / Hematometry and hematocervix in postmenopausal patient: case repor

El hematometra es la retención de sangre en el útero y comúnmente se presenta en mujeres jóvenes con anomalías mullerianas pero puede aparecer también en mujeres postmenopausicas por causas secundarias como traumas, tumores, terapia de remplazo hormonal, estenosis cervical, entre otras. En esta presentación de caso interesante se describe una mujer postmenopáusica bajo terapia de remplazo hormonal. Dicha mujer inicia con hemorragia uterina anormal por lo que se le realiza ultrasonido evidenciando hematómetra y hematocervix. Como método diagnóstico y terapéutico de la hemorragia postmenopáusica se le realiza histerectomía abdominal en la cual la patología evidencia leiomiomatosis uterina con endometrio secretor

Hematometra is the retention of blood in the uterus and commonly occurs in young women with Mullerian abnormalities but can also appear in postmenopausal women due to secondary causes such as trauma, tumors, hormone replacement therapy, cervical stenosis, among others. In this presentation an interesting case is described a postmenopausal woman under hormone replacement therapy. She said woman began with abnormal uterine bleeding, so an ultrasound was performed showing hematometer and hematocervix. As a method diagnosis and treatment of postmenopausal hemorrhage, abdominal hysterectomy is performed in which the pathology shows uterine leiomyomatosis with secretory endometrium

Útero unicorne con cuerno rudimentario no comunicante en la adolescencia / Unicornuate uterus with noncommunicating rudimentary horn in adolescence

El útero unicorne es una rara malformación uterina que resulta del desarrollo anormal de uno de los conductos de Müller. Se manifiesta habitualmente con dismenorrea, dispareunia y dolor pélvico que aparece pocos meses después de la menarquia, aunque existen casos de presentación tardía o asintomática. Los médicos deben tener en cuenta la importancia de esta rara anomalía congénita del aparato genital femenino, especialmente poco después de la menarquia porque sin un diagnóstico y tratamiento precoz, las pacientes pueden desarrollar endometriosis, infertilidad, y complicaciones graves. Presentamos el caso de una paciente de 15 años con dolor pélvico crónico originado por un útero unicorne con un cuerno rudimentario no comunicante (AU)

Unicornuate uterus is a rare uterine anomaly resulting from the abnormal development of one of the Müllerian ducts. This abnormality usually manifests with dysmenorrhea, dyspareunia and pelvic pain appearing a few months after menarche, although there are late or even asymptomatic presentations. Clinicians should be aware of the importance of this rare congenital anomaly of the female genital tract, especially when symptoms occur shortly after menarche, because without early diagnosis and treatment, patients carrying this anomaly may develop endometriosis, infertility, and severe complications. We report the case of a 15-year-old girl with chronic pelvic pain caused by a unicornuate uterus with a noncommunicating rudimentary horn (AU)

Dos casos infrecuentes de presentación del cáncer de endometrio / 2 atypical presentation cases of the endometrial cancer

Se analizan dos casos de cáncer de endometrio de presentación atípica, el primero en una mujer con radioterapia pelviana previa por un cáncer cérvicouterino, y el segundo en una paciente con antecedentes de terapia coadyuvante con tamoxifeno por un cáncer de mama. Se discute el riesgo de hacer segundos primarios en pacientes ya tratadas por una neoplasia y la eventual asociación de radioterapia pélvica y tamoxifeno con la subsiguiente aparición de un cáncer de endometrio

Himen imperforado / Imperforate hymen

Se presenta un caso clínico de himen imperforado. Se describe el rol de la ecografía en su manejo y las alternativas terapéuticas actuales

Diagnóstico ecográfico de hidro ou hematométrio associado ou näo a hidro ou hematocolpus: apresentaçäo de 5 casos / Ecographic diagnosis of hydro or hematometra associated or not to hydro or hematocolpos: report of 5 cases

Relatam-se 5 casos de hematométrio e hematocolpus. Discutem-se os resultados ecográficos característicos dessas afecçöes que säo mais freqüentes em grupos mais jovens e em idosos. Recomendam-se incorporar o ultra-som pélvico na pesquisa clínica dessas pacientes e estender o exame a outros órgäos, especialmente o sistema renal infantil