Minimally invasive approach to Herlyn-Werner-Wunderlich syndrome with giant endometriotic cyst: a case report.

Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly of the Mullerian and Wolffian ductal system, manifesting as a triad of dipelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. Patients usually remain asymptomatic till menarche and experience progressive dysmenorrhea, suprapubic lump, and/or features of infection (pyometra, pelvic collection, etc.) afterward. We hereby present a case of a young lady with Herlyn-Werner-Wunderlich syndrome with a large endometriotic cyst, likely arising from the right hemiuterus. She presented with dysmenorrhea and progressive abdominal distention for seven years. She was treated by laparoscopic ovarian cyst excision and right hemihysterectomy that relieved her symptoms.

Comparative study of intestinal malrotation in infant, children, and adult in a tertiary care center in India.

BACKGROUND: Intestinal malrotation (IM) is an uncommon condition and has varied presentation in different age groups. The study was aimed to evaluate differences in the clinical presentation, diagnosis, treatment, and outcome of IM in infants, children, and adults. METHODS: Data were collected from records of 79 patients with IM. Based on the age of presentation, these patients were categorized into three age groups: infants (up to 1 year), children (1-18 years), and adults (> 18 years). Follow up data were analyzed during 8 to 16 year after corrective surgery. RESULTS: The overall age of presentation ranged from 8 days to 60 years. Twenty-eight, 29, and 22 patients belonged to the infant, children, and adult groups, respectively. The classical presentation of IM (bilious vomiting) was significantly higher in the infant compared to the children and adult groups (100% vs. 62% vs. 9.8%; p < 0.001). All infants presented with acute symptoms. However, children and adults had subacute or chronic presentations, respectively. The incidence of volvulus was significantly higher in the infant group than other two groups, (100% vs. 41% vs. 10%; p < 0.001). Doppler ultrasound was highly accurate in infants (100%), whereas contrast-enhanced computed tomography (CECT) abdomen was found to be most useful in adults. Postoperative complications were more common in adults. CONCLUSION: Intestinal malrotation can present in patients of any age group. An increased awareness about the atypical presentations of this condition among adults may reduce the time to accurate diagnosis of this disease.