A case of wunderlich syndrome performed supra-cervical hysterectomy

症例は12歳,女性.重度の月経困難症を主訴に近医を受診し,MRI･CT検査にて子宮奇形と右腎無形成を疑われたため当科紹介となった.各種検査より重複子宮の右側子宮および卵管の留血腫と右腎無形成を認め,Wunderlich症候群と診断した.腹腔鏡で観察した後,本症例の基本術式である経膣的開窓術を試みるも施行困難であったため,開腹術による患側子宮上部切断術を施行した.術後,症状は著明に改善した.

A 12-year-old girl presented with chief complaints of severe dysmenorrhea and lower abdominal pain. Magnetic resonance imaging, computed tomography and drip infusion pyelography showed uterus didelphys with right hematometra and hematosalpinx, and right renal agenesis. Under diagnosis of Wunderlich syndrome, we performed laparoscopic exploration. Although excision of the obstructing cervix has been recommended as the first treatment for this syndrome, we couldn’t perform resection of vaginal wall. So we selected supra-cervical hysterectomy of right uterus. After surgery, her symptoms are quite improved.

Wunderlich症候群

重複子宮

子宮留血腫

腎無形成

子宮上部切断術