Venous intravasation during hysterosalpingography

Case contributed by Hoe Han Guan


Secondary infertility. History of left salpingectomy for ectopic pregnancy. To check for right tubal patency.

Patient Data

Age: 35 years
Gender: Female

Right fallopian tube could not be demonstrated beyond the corneal portion. No contrast spillage from the right fallopian tube.

Left fallopian tube is not seen in keeping with previous history of salpingectomy.

Intravasation of contrast into the myometrial vessels (lace like appearance) and subsequently into pelvic veins and right ovarian vein. On delayed spot images, the intravasated contrast dispersed.

Case Discussion

Venous intravasation is a well known complication of hysterosalpingogram. It may indirectly indicate tubal occlusion as it has been postulated that it may be caused by increasing intrauterine pressures as a result of tubal blockage. Other theories are forceful injection or endometrial disruption.

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