Presentation
History of irregular menstrual cycles with variable durations and multiple failed pregnancy attempts over the last 3 years.
Patient Data
The hysterosalpingogram reveals saccular dilations within the isthmus of both fallopian tubes, with no contrast outlet to the abdominal cavity, indicating distal obstruction.
Case Discussion
Salpingitis isthmica nodosa, also known as diverticulosis of the fallopian tubes, is a nodular thickening of the isthmic portion of the fallopian tubes, and it is associated with infertility and ectopic pregnancies. Although its aetiology is often unknown, some studies suggest some cases might be a complication of infection of the fallopian tubes, and other studies show it may be congenital or secondary from an abnormal overgrowth of the inner layer of the fallopian tube.
Hysterosalpingography is the first-line study in which infertility is suspected, like in this case, with salpingitis isthmica nodosa shown as multiple small diverticular-like formations in the proximal third of both tubes.
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