BackgroundHerlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA) are infrequently encountered in a routine clinical setting.Cases presentationtwo cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR) imaging technology to achieve the correct diagnosis.ConclusionsMR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome.

Obese subjects with coronavirus disease 2019 (COVID-19) are at increased risk of requiring critical care (1), suggesting that excess body fat associates with greater disease severity. BMI does not discriminate between fat and lean body mass and poorly reflects fat distribution. Cardiometabolic diseases and increased systemic inflammation, two conditions associated with visceral adiposity, are also linked to COVID-19 severity and fatality (1,2). The aim of this study was to assess the relationship between abdominal fat distribution and COVID-19 severity. We hypothesized that excess visceral adipose tissue (VAT), as identified by an increased VAT to subcutaneous adipose tissue (SAT) ratio (VAT/SAT), is associated with COVID-19 severity, as defined by intensive care unit (ICU) admission. This was a single-center cohort study of 441 patients consecutively admitted to the Emergency Department (ED) of the