003 HYSTEROSALPINGOGRAPHY (HSG) || CLINICAL RADIOLOGY || GENERAL RADIOLOGY || DANIEL M WASSEL.

HYSTEROSALPINGOGRAPHY (HSG) || CLINICAL RADIOLOGY

ANATOMY OF FEMALE REPRODUCTIVE SYSTEM.

* VAGINA

1.Muscular Tube 3inch Long
2.Lower Portion Of Birth Canal
3.Consist Of Labia majora And minora
4. pubic Region and hairs
**UTERUS ( WOUMB)

1.Thick Wall Muscular Organ
2. Position Changes With Fullness Of Bladder
3. It Has 3 Layers Perimetrium, myometrium and Endometrium

4. It Consist Of 4 Regions
. Fundus ( Rounded Upper Portion
. Body ( Triangular In Shape
. Isthmus ( Narrow and Constricted )
. Cervix ( Opening To Uterus ).

*** FALLOPIAN TUBE.

* Transmit Ova ( Eggs) To Uterus
* Transmit Spermatozoa From Uterus
* Site Of Fertilization In ( Ampulla)
* Divided Into 4 Parts
1. Fimbria
2. Infundibulum
3. Ampulla
4. Isthmus

Note!! Fimbria is the distal end and open into peritoneal cavity in the pelvic cavity

****OVARIES

# Two ovary on Either Sited
# Produce Ova Or eggs And Sex Hormones ( Esterogen And Progesteron)

# Almond Shape, Slightly Flattenef
# 2.5 - 5cm Long, 1cm In Thick And 2cm Wide
# Ovarian Ligament Attaches Ovary To Fallopian Tube
POSITION OF UTERUS CHANGES

Anteverted Uterus
Retroverted Uterus
Retroflex Uterus
Midposition Uterus


DEFINITION OF HYSTEROSALPINGOGRAPHY ( HSG)
1) Is The Special Radiographic/ Radiologic Examination Of Outlining The Uterus And And Fallopian Tube Using Ioding Contain Contrast media.

2) Is The Special Radiographic/ Radiologic Procedure To Demonstrate Uterus And Fallopian tube Using Contrast Media.

3) Is The Special Radiographic/ Radiologic Procedure For Investigation Of Female Genital Tract Such As Uterus And Fallopian Tube Using Contrast Media.

HSG Is For Diagnostic And Therapeutic Procedure Carryout In Radiology Department.

*****CLINICAL INDICATION FOR HSG

* Primary And Secondary Infertility
* Subfertility
* Tubal Patency
* Hydrosalpinx / Pyosalpinx
* Arsherman's Syndrome (Uterine Adhesion)
* Recurrent Abortion ( Miscarriage)
* Following Tubal Surgery
* Structural Or Functional Defect
* Localization Of Ectopic Pregnancy
* Misplace Or Loss IUCD
* Suspected Genital Tuberculosis
* Pelvic Mass
* Amenorrhea
* Endometrial Polyps
* Cervical Stenosis
* Fistula

* Congenital Uterine Abnormalities
Such As Uniconuate Uterus
Biconuate Uterus
Uterine Didelphys
Vaginal Or Uterine Agenesis
Infantile Uterus

***"Contraindications

Pregnancy
Acute PID
Menstruation Cycle
Active Pelvic Infection
Recent D & C
Vaginal Discharge
Hypersensitivity Reaction
Recent Surgery
Active Uterine Bleeding
Cervicitis

******CONTRAST MEDIA

HOM ( Urograffin)
LOM ( Scanlux)
Salpix
Sinografin
Renografin 60
Conray 60
Hypaque 50%
Hypaque M 90℅

NB:: Dilution Is 1:1 EG 10ml Of Contrast Media With 10ml Of Sterile Water For Injection.

****** EQUIPMENTS REQUIRED

Fluoroscopic Unit With Spot Film Devices
Conventional X ray Unit
Vaginal Speculum
Vulsellum Forcep
Uterine Cannula
Foleys Catheter.
Uterine Sound
Syringes 20ml & 5ml
Cotton Wool
Surgical Gloves
Garlic Pot
Methylated Spirit/ Savlon Or Dettol
******PATIENT PREPARATION.

*The 10days Rule Should Be Strictly Restrict Applies

* Patient Should Obstain From Sexual Intercourse From The Booking Of Appointment Till Procedure Date

* Examination Date Should Be Between 6th And 10days Of 10days Interval From The Onset Of Menstruation Cycle In Patient With Regular 28 Days Cycle
******PRELIM FILM

* Cone AP View Of The Pelvic Cavity

To Check For Any Calcified Lesion B4 CM Inj
To Check About Patient Preparation
To Access For Exposure Factors
*********TECHNIQUE PROPER.
1. Patient Change Into Hospital Gown.
2. Explain The Procedure To Patient But
Benefit And Risk And Obtain Consent From Him
3 Paracetamol Injection ( Im And Iv) Diclofenac
Injection IM Is Given To The Patient As Pain
Relief (Preferably 20 - 25mins Prior To The Procedure)
4. IV Buscopan Injection Is Given To Patient To Prevent Muscle Spasms ( To Relax The Patient)
5. Patient Should Lie Down In Lithotomy Position
On The Patient Couch ( Planter Surface And Heel Should Be In Contact With Table Top.

6. Using Aseptic Technique Radiographer Or Radiologist clean The Vagina And Insert Sterilized Speculum.

7. Cervix Is Sounded Using Uterine Sound. Anterior Lip Of Cervix Should Be Steadied With Vulsellum Forcep and Cannula with Contrast Media Filled Syringe At The Other End Is ScrewScrewed Into Cervical Canal

8. Care Should Be Taken To Expel Air In Both Cannula And Syringe B4 Administration

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