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Female genital tract

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hysterosalpingogram: Kidde technique


instruments
  • single-toothed tenaculum: maintain seal and provide traction
  • acorn tip
  • Kidde cannula

contrast

  • Sinografin (meglumine diatrizoate/iodipamide)
  • Renografin (meglumine iothol diatrizoate) both water soluble
  • advantages:
    • quicker filling
    • better visualization
    • absorbed rapidly from peritoneum
    • no vasc embol of particulates
    • no local inflamm rxn
  • disadvantage: increased pain with rapid distention

technical problems

  • contrast instilled too quickly hides subtle abnormality:
    • small polyp
    • small leiomyoma
    • synechiae
  • leak around os due to patulous or stenotic cervix
  • bicornuate or septate uterus (use shorter tip)
  • lack of tubal filling: nonspecific finding
    • may be technique, cornual spasm, mucous plug
    • reinject with Glucagon 1mg

positive findings

  • peritoneal spillage if rugal fold of ampulla seen
  • contrast may loculate in peri-fimbrial adhesion


Ruth Carlos, MD  -  10 January 1996
Last updated:  1 October 2013


 

Related CHORUS documents:
hysterosalpingogram (HSG)
ovarian cyst
Meigs syndrome
Nabothian cyst
ovarian stromal tumors
ovarian tumors

 

Copyright © 2013, Charles E. Kahn, Jr.