A case of prolonged retention of lipiodized oil suspicious for foreign material in the abdomen

Abstract

  Lipiodized oil has been widely used for hysterosalpingography because it has superior imaging capability. We report a case of prolonged retention of lipiodized oil suspicious for foreign material in the abdomen. A 34-year-old woman who had undergone hysterosalpingography for evaluation of primary infertility visited our hospital with complaints of lower abdominal pain. She was found to have a metal-like shadow in the right side of the pelvis that was present on abdominal radiography performed at another facility. Computed tomography showed a high absorption range with halation in the right side of the pelvis. We suspected retention of metallic material because she had a history of cesarean section in our hospital several years prior, but we did not consider the likelihood of prolonged retention of lipiodized oil. Laparoscopic surgery was performed for diagnosis. During the operation we did not find any metallic material in the pelvis; we confirmed the position of the mass by using X-ray imaging and resected a cystic mass from the right side of the pelvis. The cyst showed high absorption on radiography and contained a yellowish oily fluid. We carried out a combustion experiment and it was found that the oily fluid included iodine; we therefore concluded that the cystic mass was due to prolonged retention of lipiodized oil rather than metallic material. It is necessary to consider the possibility of prolonged retention of lipiodized oil in patients with a history of hysterosalpingography.