The Teaching Point

Venous intravasation is a well described phenomenon in hysterosalpingography in which contrast transits from the uterine cavity directly to myometrial vessels, then to draining pelvic veins. This is a potential pitfall in HSG interpretation, particularly in post-Essure confirmatory HSGs, as the intravasated contrast can mimic free intraperitoneal spillage of contrast, e.g. from patent fallopian tubes or uterine perforation.






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From the manuscript

Venous Intravasation: A Potential Pitfall of Confirmatory Hysterosalpingogram Following Essure Hysteroscopic Sterilization.

Free full text article: Venous Intravasation: A Potential Pitfall of Confirmatory Hysterosalpingogram Following Essure Hysteroscopic Sterilization.

Abstract
Indications for hysterosalpingography (HSG) include evaluation of infertility, spontaneous abortions, postoperative evaluation of tubal ligation, pre-myomectomy evaluation, and more recently, evaluation of tubal occlusion after placement of the Essure Permanent Birth Control System. Here we report a case of venous intravasation during a routine post-Essure HSG, a phenomenon in which contrast transits from the uterine cavity, through the myometrium, and directly into draining pelvic veins. Venous intravasation is a potential pitfall in interpretation of HSGs.






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