Asherman syndrome

Case contributed by Dr Ivan Pedrollo

Presentation

Infertility investigation.

Patient Data

Age: 35 years
Gender: Female
Modality: Fluoroscopy

The hysterosalpingography demonstrated classical findings of intrauterine adhesions (Asherman syndrome), the triangular-shaped filling defects in the uterine cavity.

In addition, left hydrosalpinx was identified, characterised by dilation of the ampullary part of the fallopian tube and the absence of extravasation of contrast into the peritoneal cavity on this side.

Case Discussion

The patient had a previous history of uterine curettage abortion at age 16. Also, at age 24, the patient had a suspected appendicitis, but the laparoscopy demonstrated right salpingitis. Appendectomy was then performed in the same manner.

The findings described of intrauterine adhesions on hysterosalpingography are consistent with the previous history of uterine curettage, the main cause of Asherman syndrome

In addition to this finding, hydrosalpinx on the left was also identified, which can be a tubal cause of infertility. This condition is closely associated with pelvic inflammatory disease (PID), usually caused by organisms such as chlamydia or gonococcus. The history of suspected appendicitis which turned out to be salpingitis also illustrates that the disease was bilateral and had probably just left sequelae.

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Case Information

rID: 31328
Case created: 1st Oct 2014
Last edited: 13th Mar 2016
System: Gynaecology
Inclusion in quiz mode: Included

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