A Case Report of Oblique Vaginal Septum Syndrome with Difficulty in Defecation as the Initial Symptom

Abstract

Oblique vaginal septum syndrome (OVSS) is a rare congenital disorder characterized by uterus didelphys, hemivaginal septum, and unilateral renal agenesis. Its clinical characteristics vary among different patients. Herein we report a case of OVSS with difficulty in defecation as the initial symptom and diagnosed with ultrasound and laparoscopic exploration. This 13-year-old girl was admitted to our hospital with the complaint of difficulty in defecation for more than 1 month and difficulty in urination for 6 days. Her ultrasound test showed that the left kidney was not displayed, and the right kidney was compensatory enlargement. A giant cystic-solid mass (110 mm × 96 mm × 87 mm) was seen in the pelvic cavity. Under laparoscopy, a huge mass was seen in the abdominal cavity. The surface resembled the seromuscular layer of the uterus. A uterine organ was seen on both sides of the tumor, and both fallopian tubes and ovaries were connected. The size of the right uterus was about 3 cm × 2 cm. The right fallopian tube and ovary were normal in appearance. The left uterus was enlarged (about 6 cm x 5 cm). The left fallopian tube was enlarged and contained a large amount of brown blood stains, and blood stains were seen flowing out from the umbrella end. The hysteroscopic incision and repair surgery were then performed. Most patients with OVSS presented with dysmenorrhea, abdominal pain, pelvic mass, and foul mucopurulent discharge, while in this case, difficulty in defecation was the initial symptom. Thus, this case report provided evidence supporting the heterogeneity of this disorder.