• A 30 years old lady
  • Investigation for infertility
  • Ultrasound shows retroverted uterus

Hysterosalpingogram findings:

  • Uterus in retroverted.
  • Uterine cavity shows normal outline and no filling defect within it
  • There is spillage from right side (white arrows).
  • The proximal left fallopian tube is normal in calibre.
  • However the tube is dilated distally with no evidence of contrast spillage on the left side (yellow arrows)

Radiological diagnosis: Left hydrosalpinx


  • A hydrosalpinx is a condition that occurs when the fallopian tube is blocked and fills with fluid.
  • If the fluid is infected, i.e. pus, then it is a pyosalpinx and if it is bloody, it is then haematosalpinx.
  • The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape.
  • The condition is often bilateral and the affected tubes may reach several centimeters in diameter. The blocked tubes cause infertility.
  • Hydrosalpinx may be diagnosed using ultrasoundas the fluid filled elongated and distended tubes display their typical echolucent pattern. However, a small hydrosalpinx may be missed by sonography.
  • Hysterosalpingogram )HSG) shows the retort-like shape of the distended tubes and the absence of spillage of the dye into the peritoneum. If, however, there is a tubal occlusion at the utero-tubal junction, a hydrosalpinx may go undetected.
  • MRI and CT scan may also demonstrate the dilated fallopian tubes.
Author: radhianahassan