title: A Case of Obstructed Hemivagina with Ectopic Ureter Leading to Severe Hydrocolpos and Contralateral Renal Outflow Tract Obstruction in a Neonate.
abstract: BACKGROUND
  Renal and Müllerian anomalies are frequently associated. Young age at presentation can present challenges in diagnosis and management. We report a case with an unusual presentation and management of this association in the neonatal period.
  
  
  METHODS
  A 2-day-old girl had hydronephrosis with a large pelvic fluid collection. Magnetic resonance imaging of the pelvis demonstrated right hydronephrosis and uterine didelphys with an obstructed left hemivagina with hydrocolpos. A tube vaginostomy was used to decompress the vagina. Fluid was consistent with urine from an ectopic ureteral implantation from a dysgenetic left kidney, which was removed.
  
  
  CONCLUSIONS
  For obstructed hemivagina in a newborn, expanding fluid collections may be addressed with a drain to avoid mass effect and to aid in the diagnosis. Resection of the vaginal obstruction is performed when the patient is older. A nonfunctional kidney can be removed to eliminate fluid accumulation in the obstructed space.
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas. Electronic address: roshi.mansouri@gmail.com.
authors.forename: Roshanak
authors.initials: R
authors.lastname: Mansouri
authors.affiliation: Division of Pediatric Urology, Scott Department of Urology, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas.
authors.forename: James C
authors.initials: JC
authors.lastname: Sander
authors.affiliation: Division of Pediatric Urology, Scott Department of Urology, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas.
authors.forename: Nicolette K
authors.initials: NK
authors.lastname: Janzen
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Texas Children's Hospital, Houston, Texas.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
mesh_terms: D020884:Colpotomy; D005260:Female; D006801:Humans; D052202:Hydrocolpos / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006869:Hydronephrosis / Q000209:etiology* / Q000601:surgery; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D014513:Ureter / Q000002:abnormalities*
keywords: Ectopic ureter; Hydrocolpos; Hydronephrosis; Müllerian anomalies; Neonates; Obstructed hemivagina; Renal outflow tract obstruction