Diagnostic Utility of Pre and Post HSG Transvaginal Sonography: The Birth of a New Beginning

Background: The use of ultrasonography in the investigation of infertility has progressed rapidly and has currently become an integral part of the management of infertility in women. The advent of pre and post hysterosalpingogram (HSG) sonography has anecdotally improved the sensitivity and specificity of HSG in the assessment of tubal anomalies. Aim: To report a case of a peritoneal spillage of contrast during HSG which did not reveal fluid in the pouch of Douglas on abdominal and tranvaginal sonography. Methods: A case of pre and post HSG transvaginal sonography is reported with review of relevant literature. Results: HSG showed bilateral spillage of dye without any significant increase in pouch of Douglas fluid on pre and post HSG ultrasongraphy Conclusion: Pre and post HSG sonography have improved the HSG diagnostic accuracy of tubal normalcy as against patency. The quantity of fluid in the pouch of Douglas in the post HSG sonogram (culdosonogram) gives an indication of a free or localized peritoneal spillage. Key Words: hysterosalpingogram, 'culdosonography', Gynaecology.