Accidental injection of the uteroovarian venous system during lipiodol uterosalpingography

and

*Presented at the Fifth Annual Mile&in g of the C‘entral Gynecologists. Milwaukw, Wis.. Ovtoher 5. 1932, !,I”

Association

of Obstetricians

COVENTRY

:

I ,II’IODOL

l~TEROYAI~I’IN(;IO~:RAP~IY

9 13

had penetrated into the sinuses of the uterus and passed out into the uteroovarian veins on the right sidr of the pelvis and to a lesser degree into the veins of the left side. The patient immediately coml~lninrtl of feeling chilly and nauseated, breathed rapidly, and felt, as she expressed it, “knocked out ” the reaction laeting about twenty minutes. It was necessary for her to lie down (luring this period, I)ut at no time were her symptoms alarming. A picture of the pelvis taken one hour later showed that the lipiotlol hall entirely disappeared, as will be seen by the corresponding slides (Figs. 1 and 2). The accidental injection of lipiodol into the uteroovarian venous system hy way of the uterine sinuses may take place when doing a uterosalpingography in spite of all precautionary methods that may he used. A similar accillcnt oceur-

ring with gas in place of lipiodol would probably prove fatal. In the case reported the cause may 1~ the faulty use of the cnnnula or some anomaly of the uterine sinuses. The acci~lrntal injection of the uteroovarian venous system with lipiodol as rcportrtl in the six casts found in the literature and the case I have to report tollay, occasions no alarming symptoms or fatalities. Lipiodol uterosalpingography is for this rrason niuch to he prcferrcd to gas injection under like circumstances. REFERENCES

Bmcll, Banrell, mnd Riem: J. de Radiologie et d’Electrotogie 13: 38, 1929. IVitwer, E. E., Cushman, H. P., and Lrucstia, l’.: Am. J. Roentgenol. 23: 126, 1930. R7on.g. F?J’q awd Chien.: Chinese hf. J. 46: (Xi, 19%. Sampson: Am. J. Old.

78:

161,

1918.

Moenol~.:

J. A. M.

A. 89: 522, 192X.