MRIで腟留血腫の経時的縮小を認め，不完全閉塞型が疑われたOHVIRA症候群の1例

A case of obstructed hemivagina and ipsilateral renal anomaly（OHVIRA）syndrome

OHVIRA（obstructed hemivagina and ipsilateral renal anomaly）症候群とは，重複子宮，重複腟，片側腟閉鎖に同側腎奇形を合併する，まれな症候群である。腟中隔閉塞の程度により，完全閉塞型と不完全閉塞型に分類される。今回我々は，腹部症状の増悪と軽快を繰り返し，不完全閉塞型が疑われたOHVIRA症候群の1例を経験したので，若干の文献的考察を加えて報告する。

A 21-year-old woman presented with recurrent lower abdominal pain. Pelvic MRI revealed uterus didelphys, vagina didelphys, right vaginal atresia and vaginal hematoma, and abdominal ultrasonography revealed right renal agenesis. For these image findings, obstructed hemivagina and ipsilateral renal anomaly（OHVIRA）syndrome was diagnosed. Surgery was scheduled, but symptoms were in spontaneous remission and the patient had been followed-up. Five years later, the patient presented with increased menses with no complaint of abdominal pain. On pelvic MRI, the right vaginal hematoma decreased. For these clinical and image findings, the patient was diagnosed with the incomplete vaginal obstruction type. This syndrome seems to be difficult to diagnose only by gynecological examination and ultrasonography. MRI is helpful to evaluate morphological abnormality of uterus and vagina noninvasively and objectively.