title: Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome due to microperforation and pyocolpos in obstructed vaginal canal.
abstract: BACKGROUND
  To present a rare anomaly consisting of uterus didelphys, longitudinal vaginal septum, obstructed hemivagina with pyocolpos, fistula to the open vaginal canal, and ipsilateral renal agenesis, referred as Herlyn-Werner-Wunderlich syndrome (HWWS).
  
  
  METHODS
  A 14-year-old girl with recurring purulent vaginal discharge lasting for a few months. Preoperative examination revealed one vaginal canal with one cervical opening on the right side. There was a fistula leading from the obstructed vaginal canal to the left vagina. Intravaginal ultrasound examination demonstrated a longitudinal vaginal septum and a closed pyocolpos on the right side. The longitudinal vaginal septum was excised by way of electrocauterization under direct vision.
  
  
  CONCLUSIONS
  HWWS should be considered in the differential diagnosis in patients with uterus didelphys and unusual symptoms such as pyocolpos and vaginal discharge.
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland. Electronic address: ewa.wozniakowska@gmail.com.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wozniakowska
authors.affiliation: Department of Human Anatomy, Medical University of Lublin, Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Torres
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Milart
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Wozniak
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czuczwar
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Szkodziak
authors.affiliation: Department of Gynecology, Medical University of Lublin, Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Paszkowski
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis*; D000293:Adolescent; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D013492:Suppuration / Q000209:etiology; D013577:Syndrome; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery; D019522:Vaginal Discharge / Q000209:etiology*; D014624:Vaginal Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery
keywords: Fistula; Herlyn-Werner-Wunderlich syndrome; Longitudinal vaginal septum; Purulent vaginal discharge; Pyocolpos