Objectives:Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation.Materials and Methods:This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software.Results:Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation.Conclusions:Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.
Acoustic radiation force impulse elastography is a rapid, radiation-free, and noninvasive tool for diagnosis of acute pancreatitis at initial hospital admission, with a higher success rate for diagnosis of acute pancreatitis than the grayscale sonography and CT.
Extrahepatic abdominal hydatid lesions have nearly identical imaging features, including the presence of cyst wall calcification, daughter cysts, and membrane detachment. The combinations of radiologic and serologic tests especially in patients living in the endemic areas contribute to the diagnosis. Despite their rarity, being familiar with the spectrum of radiologic findings in these unusual sites is helpful to improve diagnostic accuracy.
Anthrax continues to be an endemic disease in Turkey, and should be considered in patients with a relevant contact history having a painless ulcer and vesicular skin lesions surrounded by a zone of oedema. Gram staining and simple culture methods are useful aids to diagnosis, but diagnosis may have to be based on clinical grounds in the majority of patients.
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