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[Adnexal defect identified with hysterosalpingogram and laparoscopy during infertility evaluation]
E-S Sills1, M Perloe, D-P Levy
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, Atlanta Medical Center, Atlanta, Georgia, Etats-Unis. dr.sills@ivf.com
Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|February 20, 2003
Summary
A novel adnexal defect, a physiologic aperture in the broad ligament, was identified as a cause of abnormal hysterosalpingogram (HSG) during infertility evaluation. This previously unreported finding can explain radiographic abnormalities in select infertility cases.
Area of Science:
- Reproductive Medicine
- Diagnostic Imaging
- Surgical Anatomy
Background:
- Hysterosalpingography (HSG) is a key diagnostic tool in infertility evaluations.
- Abnormal HSG findings often suggest tubal pathology or uterine abnormalities.
Observation:
- An abnormal HSG mimicking tubal obstruction was observed in a nulligravida patient.
- Laparoscopy revealed a previously unreported physiologic aperture in the broad ligament, explaining the HSG defect.
Findings:
- The adnexal defect was a 3x4cm ovoid aperture in the left broad ligament.
- The defect was explored but not repaired, and bilateral tubal patency was confirmed.
Implications:
- This case describes a novel cause of abnormal HSG findings.
- Intrinsic peritoneal defects should be considered in the differential diagnosis of unexplained HSG abnormalities during infertility assessments.