hysterosalpingogram: Kidde technique

• 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

© 2002, C.E. Kahn, Jr.
2002-04-18