{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:28:21Z","timestamp":1793726901783,"version":"4.6.1"},"reference-count":19,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,4,26]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Obstructed Hemi Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rarely encountered m\u00fcllerian duct anomaly. Delayed diagnosis is common due to normal onset of puberty and menstruation. We report a case of a woman in her early 20s with a background history of multiple emergency department visits, ward admissions and surgeries for chronic abdominal pain. She was reviewed at 1\u2009month postlaparotomy for recurrent pelvic abscess and was finally diagnosed to have an OHVIRA syndrome, 11 years after her first clinical presentation. Excision of the vaginal septum completely resolved her symptoms. We are reporting this case to highlight the clinical implications resulting from the delayed diagnosis, to look into factors contributing to the delay and to highlight the importance of having a high index of suspicion to diagnose this unique condition.<\/jats:p>","DOI":"10.1136\/bcr-2024-259861","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T23:46:34Z","timestamp":1716421594000},"page":"e259861","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["OHVIRA syndrome: clinical implications of a delayed diagnosis"],"prefix":"10.1136","volume":"17","author":[{"given":"Fadzlin","family":"Mohd Adzlan","sequence":"first","affiliation":[{"name":"Department of O&G, Ministry of Health, Hospital Sultanah Nur Zahirah\/Hospital Kemaman, Kuala Terengganu\/Kemaman, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karimah","family":"Mohd","sequence":"additional","affiliation":[{"name":"Department of O&G, Ministry of Health, Hospital Sultanah Nur Zahirah\/Hospital Kemaman, Kuala Terengganu\/Kemaman, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasriah","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of O&G, Ministry of Health, Hospital Sultanah Nur Zahirah\/Hospital Kemaman, Kuala Terengganu\/Kemaman, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0914-6079","authenticated-orcid":false,"given":"Roziana","family":"Ramli","sequence":"additional","affiliation":[{"name":"Department of O&G, Ministry of Health, Hospital Sultanah Nur Zahirah\/Hospital Kemaman, Kuala Terengganu\/Kemaman, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"2025082722360512000_17.5.e259861.1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116738"},{"key":"2025082722360512000_17.5.e259861.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpurol.2021.06.023","article-title":"Multiple variants of obstructed Hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome - one clinical center case series and the systematic review of 734 cases","volume":"17","author":"Kudela","year":"2021","journal-title":"J Pediatr Urol"},{"key":"2025082722360512000_17.5.e259861.3","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.ejogrb.2022.06.013","article-title":"Conservative treatment of Herlyn-Wernerwunderlich syndrome: analysis and long-term follow-up of 51 cases","volume":"275","author":"Candiani","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082722360512000_17.5.e259861.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0497-y"},{"key":"2025082722360512000_17.5.e259861.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3286-5"},{"key":"2025082722360512000_17.5.e259861.6","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/0009922820953582","article-title":"Diverse presentations of OHVIRA syndrome: A case series","volume":"60","author":"Jha","year":"2021","journal-title":"Clin Pediatr (Phila)"},{"key":"2025082722360512000_17.5.e259861.7","doi-asserted-by":"crossref","first-page":"407","DOI":"10.18597\/rcog.3699","article-title":"Herlyn-Werner-Wunderlich Syndromne: case review and report of the literature","volume":"72","author":"Guti\u00e9rrez-Montufar","year":"2021","journal-title":"Rev Colomb Obstet Ginecol"},{"key":"2025082722360512000_17.5.e259861.8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jpag.2014.09.008","article-title":"Obstructed Hemivagina with ipsilateral renal anomaly","volume":"29","author":"Santos","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025082722360512000_17.5.e259861.9","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det081"},{"key":"2025082722360512000_17.5.e259861.10","article-title":"OHVIRA syndrome pre-Operatively diagnosed using Vaginoscopy and Hysteroscopy: A case report","volume":"1","author":"Mabuchi","year":"2021","journal-title":"Med Int (Lond)"},{"key":"2025082722360512000_17.5.e259861.11","doi-asserted-by":"crossref","first-page":"021","DOI":"10.17352\/2455-5282.000006","article-title":"An unusual case of recurrent Pyocolpos following midtrimester Miscarriage revealed as obstructed Hemivagina with ipsilateral renal Agenesis (OHVIRA) syndrome","volume":"1","author":"Khandaker","year":"2014","journal-title":"Glob J Medical Clin Case Rep"},{"key":"2025082722360512000_17.5.e259861.12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ejogrb.2021.03.018","article-title":"Obstructed Hemivagina and ipsilateral renal anomaly (OHVIRA): early diagnosis, treatment and outcomes","volume":"261","author":"Yang","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082722360512000_17.5.e259861.13","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1016\/j.jpag.2013.07.009","article-title":"Delayed diagnosis of Herlyn-Wernerwunderlich syndrome due to Microperforation and Pyocolpos in obstructed vaginal canal","volume":"27","author":"Wozniakowska","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025082722360512000_17.5.e259861.14","first-page":"156","article-title":"Uterus Didelphys with blind Hemivagina and ipsilateral renal Agenesis complicated by Pyocolpos and presenting as acute abdomen 11 years after menarche: presentation of a rare case with review of the literature","volume":"35","author":"Varras","year":"2008","journal-title":"Clin Exp Obstet Gynecol"},{"key":"2025082722360512000_17.5.e259861.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2004.01.016"},{"key":"2025082722360512000_17.5.e259861.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.11.015"},{"key":"2025082722360512000_17.5.e259861.17","doi-asserted-by":"crossref","unstructured":"Kamal EH , Ayoub A , Ibtissam B , et al . n.d. \u201cA rare Urogenital malformation \u201cHerlynwerner-Wunderlich syndrome\u201d (Ohvira syndrome) discovered during an acute pelvic pain\u201d. Int J Reprod Contracept Obstet Gynecol 12:1143\u20138. doi:10.18203\/2320-1770.ijrcog20230829","DOI":"10.18203\/2320-1770.ijrcog20230829"},{"key":"2025082722360512000_17.5.e259861.18","first-page":"1253","article-title":"The Herlyn-Werner-Wunderlich Triad (OHVIRA syndrome) with good pregnancy outcome - two cases and literature review","volume":"59","author":"Albulescu","year":"2018","journal-title":"Rom J Morphol Embryol"},{"key":"2025082722360512000_17.5.e259861.19","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jpag.2023.07.008","article-title":"Pregnancy outcomes in patients with obstructed Hemivagina ipsilateral renal Agenesis","volume":"36","author":"Erkkinen","year":"2023","journal-title":"J Pediatr Adolesc Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-259861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:36:21Z","timestamp":1756359381000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-259861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,22]]},"published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1136\/bcr-2024-259861"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-259861","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}