Role of Hysterosalpingosonography in Diagnosing Pyosalpinx

Abstract

The purpose of the study was to distinguish hydrosalpinx/pyosalpinx from other adnexal masses by hysterosalpingosonography(HSS) using spring water. Here we report a case of 30 years old female who presented with complains of secondary infertility, previous two ultrasounds done showed endometriotic cyst/ T.O. mass. Since she had secondary infertility the gynaecologist wanted to know the status of her tubes hence advised tubal patency test. On ultrasound we found a complex mass on left side predominantly cystic with internal echoes and some solid tissue at the periphery measuring 9.0 x 8.0 cms. She was than subjected to HSS(hysterosalpingosonography) with spring water(a new technique) for testing her tubal patency. HSS was done using spring water for testing her tubal patency and comet tail artifact of spring water were seen spurting out into the mass from the interstitial end of uterus confirming the diagnosis of pyosalpinx. This was further confirmed on laproscopy. Paper will highlight the entire procedure recorded on videotape at our centre and will show the moving micro air bubbles into the adnexal mass(pyosalpinx) which was initially thought to be endometriotic cyst/ T.O. mass.