Background

We describe a minimally invasive, image-guided technique for obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome complicated by tubo-ovarian abscess (TOA).

Case

A 15-year-old female adolescent with OHVIRA syndrome presented with TOA. Magnetic resonance imaging of the abdomen/pelvis showed a loculated pelvic mass and fluid collection near the obstructed left hemivagina. Tissue quality and ill-defined surgical planes prevented surgical excision. A transabdominal drain was placed via laparoscopic port by Interventional Radiology. She later underwent transvaginal and transabdominal drain placement into the hemivaginal collection using computed tomography and ultrasound guidance, allowing for surgical excision of the vaginal septum, drainage and excision of the TOA, and neosalpingostomy.

Summary and Conclusion

Because of the anatomic complexity in OHVIRA syndrome, preoperative minimally invasive techniques with Interventional Radiology collaboration can assist intraoperative anatomic navigation for successful surgical treatment.

中文翻译：

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图像引导的经阴道和经腹引流放置在输卵管卵巢脓肿和半阴道梗阻和同侧肾脏异常综合征患者的手术导航中

背景

我们描述了一种微创、图像引导技术，用于治疗并发输卵管卵巢脓肿 (TOA) 的半阴道梗阻和同侧肾异常 (OHVIRA) 综合征。

案件

一名患有 OHVIRA 综合征的 15 岁女性青少年出现 TOA。腹部/骨盆的磁共振成像显示在阻塞的左侧半阴道附近有一个封闭的骨盆肿块和积液。组织质量和不明确的手术平面阻碍了手术切除。介入放射学通过腹腔镜端口放置经腹引流管。后来，她使用计算机断层扫描和超声引导将经阴道和经腹引流管置入半阴道集合中，允许手术切除阴道隔膜、引流和切除 TOA，以及新输卵管造口术。

总结与结论

由于 OHVIRA 综合征的解剖结构复杂，术前微创技术与介入放射学合作可以协助术中解剖导航以实现成功的手术治疗。