*27-year-old female with infertility.
What is the most likely diagnosis?
Answer
Answer: Lymphatic and venous intravasation
Case Discussion:
HSG showing a normal uterus and tubes. At 5 min after injection, lymphatic and venous intravasation is seen during HSG as a network of thin vessels filled with contrast around the uterus.
The incidence of venous or lymphatic intravasation on HSG in literature varies from 0% to 6%. The radiologic appearance of lymphatic and venous intravasation can be difficult to distinguish. Though venous or lymphatic intravasation can occurs in healthy patients, there are some predisposing factors such as uterine scarring, tubal obstruction, recent uterine surgery, misplacement of the cannula tip, and excessive pressure during the injection of contrast material.
References:
- Yoder IC. Hysterosalpingography and pelvic ultrasound: imaging in infertility and gynecology. Boston: Little, Brown, 1988: 23-28, 133-193.
- Siegler AM, Hysterosalpingography. Fertil Steril 1983; 40: 139-158.
- Úbeda B, Paraira M, Alert E, Abuin RA. Hysterosalpingography: spectrum of normal variants and nonpathologic findings. AJR 2001; 177: 131-135.