2022 Volume 74 Issue 1 Pages 166-170
Oil-based iodinated contrast media are widely used for hysterosalpingography. Oil-based iodinated contrast media can remain in the body for extended periods of time, which can show a CT value similar to that of metal on radiographic evaluation, which may result in misdiagnosis of such lesions postoperatively. We describe a patient with a history of hysterosalpingography, who presented with a shadow that was misdiagnosed as a metallic foreign body on radiography performed after cesarean delivery. The patient conceived after thawed blastocyst transplantation. She underwent an emergency cesarean delivery, and postoperative radiography revealed a pelvic mass with a clear margin and an area of uniformly high absorption. Computed tomography (CT) revealed a suspected foreign body on the right side of the Douglas fossa with a CT value of 3000 Hounsfield units (HU), which was comparable to that of metal. The patient’s re-interview revealed a history of hysterosalpingography ; therefore, based on a literature review, we strongly suspected residual contrast medium in the abdominal cavity, and the patient was followed-up without any intervention, per our hospital policy. Subsequent radiography revealed deformation and reduction in the size of the shadow, and the patient was diagnosed with residual oil-based iodinated contrast medium in the abdominal cavity. It is necessary to remember the possibility of residual contrast media in patients with a history of hysterosalpingography. [Adv Obstet Gynecol, 74(1) : 166-170, 2022 (R4.2)]
