Main Text
A 36-year-old nulliparous woman with 40 weeks of gestation was admitted
to our department due to premature rupture of the membranes. The
hysterosalpingogram had been performed with 4 ml of lipiodol
approximately 10 months prior to her presentation, and the fallopian
tube was normal. An emergency cesarean section was performed as
intrauterine infection was suspected. The child’s condition at birth was
uneventful. Postoperative abdominal x-ray showed high enhancement
shadows (Fig.1). It was confirmed that no gauze and instrument was lost
at the end of the surgery. Abdominal CT images showed high density
shadows outside the abdominal cavity along the inguinal canal (Fig.2),
suggesting the presence of a metal-device. The surgical removed object
was a cystic mass about 2 cm in diameter with a yellow liquid.
Mass-spectrometry showed the substance was highly consistent with the
same lot number of lipiodol used at the previous clinic. There are a few
case reports of intraperitoneal remnants of lipiodol (1-2). In our case,
it was found outside the abdominal cavity. Gynecologists should keep in
mind the possibility of contrast agent remnants when examining X-ray
images on the patient with a history of hysterosalpingogram.