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Entrance of lipiodol into ovarian and other veins during uterography
ENTRANCE
OF LIPIODOL IKTO OVARIAN DVRING UTEBOGRAPHY
AND OTHER
NILROE. B.A.. KD., AND ALFRED B.A., M.D.> F.A.C.S., SEW YORK, N.
JOHN
CHARLES
M.
\‘EINS
HELLXAK.
T.
ELIEVING that the condition presented by the following case is still generally No similar case report could be found unknown, we heremith offer this report. B in the literature up to 1932, and one of our largest clinics reported never to have seen such a case.
Fig.
I.--Roentgenogram
talcen
directly
after
injection
of
lipiodnl.
Mrs. M. N., age thirty, was born in Italy and has been in the United States for ten years. She has been married six yesrs; has never been pregnant. Her menses started at 13, are regular, of the twenty-eight day type, and last six to, seven days; the bleeding is scanty and there is no pain. For four years the menses have been becoming less frequent and more scanty. She came to the Lenox Hill Hospital CYinie because of this reduction in her menses, her seeming sterility, and complaining of some indefinite pain on the right side of the abdomen, low down. Two examinations of the uterus and tubes by means of the injection of lipiodol into the uterine cavity demonstrated an apparent intravisation of lipiodol into the vessels of the uterine wall, and outlined both ovarian veins. This is easily seen from the accompanying pictures (Figs. 1 and 2). Bimanual examination is entirely neg152
KILROE
AND
HELLMAN:
ENTRANCE
ative, and no direct cause for the phenomenon is finding is most unusual. Bobin and Schapiro in tine (Vol. 205, p. 380) showed a picture of this injecting lipiodol into the extirpated uterus, using living subject no undue pressure was used, and the
Fig.
Z.-Taken
three
minutes
after
OF
LIPIODOl>
153
This demonstrable in this patient. the New England Journal of 3@etf icondition which they produce d by In our case 01n the great pressure. process was not at all painful.
injection
of
lipiodol.
Three thcorics for the production of this phenomenon are mentioned: 1. Injection under high pressure. 3. Injection after injury of the mucous membrane of the uterine mall, as with a curette. 3. Softening and permeability of the vessel walls. Seithcr of the first two reasous are applicable to our case, and no undue softc ming or permeability of the vessel walls could be demonstratrd unless the phenom Lenon herewith described demonstrates that such permeability of the vessels exists. 1114 MADISON 41 EAST 781~
AVENUE. QTREET.
OF LIPIODOL IKTO OVARIAN DVRING UTEBOGRAPHY
AND OTHER
NILROE. B.A.. KD., AND ALFRED B.A., M.D.> F.A.C.S., SEW YORK, N.
JOHN
CHARLES
M.
\‘EINS
HELLXAK.
T.
ELIEVING that the condition presented by the following case is still generally No similar case report could be found unknown, we heremith offer this report. B in the literature up to 1932, and one of our largest clinics reported never to have seen such a case.
Fig.
I.--Roentgenogram
talcen
directly
after
injection
of
lipiodnl.
Mrs. M. N., age thirty, was born in Italy and has been in the United States for ten years. She has been married six yesrs; has never been pregnant. Her menses started at 13, are regular, of the twenty-eight day type, and last six to, seven days; the bleeding is scanty and there is no pain. For four years the menses have been becoming less frequent and more scanty. She came to the Lenox Hill Hospital CYinie because of this reduction in her menses, her seeming sterility, and complaining of some indefinite pain on the right side of the abdomen, low down. Two examinations of the uterus and tubes by means of the injection of lipiodol into the uterine cavity demonstrated an apparent intravisation of lipiodol into the vessels of the uterine wall, and outlined both ovarian veins. This is easily seen from the accompanying pictures (Figs. 1 and 2). Bimanual examination is entirely neg152
KILROE
AND
HELLMAN:
ENTRANCE
ative, and no direct cause for the phenomenon is finding is most unusual. Bobin and Schapiro in tine (Vol. 205, p. 380) showed a picture of this injecting lipiodol into the extirpated uterus, using living subject no undue pressure was used, and the
Fig.
Z.-Taken
three
minutes
after
OF
LIPIODOl>
153
This demonstrable in this patient. the New England Journal of 3@etf icondition which they produce d by In our case 01n the great pressure. process was not at all painful.
injection
of
lipiodol.
Three thcorics for the production of this phenomenon are mentioned: 1. Injection under high pressure. 3. Injection after injury of the mucous membrane of the uterine mall, as with a curette. 3. Softening and permeability of the vessel walls. Seithcr of the first two reasous are applicable to our case, and no undue softc ming or permeability of the vessel walls could be demonstratrd unless the phenom Lenon herewith described demonstrates that such permeability of the vessels exists. 1114 MADISON 41 EAST 781~
AVENUE. QTREET.