Diagnostic Utility of Pre and Post HSG Transvaginal Sonography: The Birth of a New Beginning

OA Onyegbule, AC Ugwu


Background: The use of ultrasonography in the
investigation of infertility has progressed rapidly and has
currently become an integral part of the management of
infertility in women. The advent of pre and post
hysterosalpingogram (HSG) sonography has anecdotally
improved the sensitivity and specificity of HSG in the
assessment of tubal anomalies.
Aim: To report a case of a peritoneal spillage of contrast
during HSG which did not reveal fluid in the pouch of
Douglas on abdominal and tranvaginal sonography.
Methods: A case of pre and post HSG transvaginal
sonography is reported with review of relevant literature.
Results: HSG showed bilateral spillage of dye without any
significant increase in pouch of Douglas fluid on pre and post
HSG ultrasongraphy
Conclusion: Pre and post HSG sonography have improved
the HSG diagnostic accuracy of tubal normalcy as against
patency. The quantity of fluid in the pouch of Douglas in the
post HSG sonogram (culdosonogram) gives an indication of
a free or localized peritoneal spillage.

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