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• W2080811081 abstract "A woman presented with vaginal bleeding after myomectomy. Ultrasonography, magnetic resonance imaging (MRI), and three-dimensional computed tomography (CT) combined with hysterosalpingography (HSG) revealed an iatrogenic diverticulum of the uterus. The three-dimensional CT combined with HSG images were very useful for subsequent surgery. A woman presented with vaginal bleeding after myomectomy. Ultrasonography, magnetic resonance imaging (MRI), and three-dimensional computed tomography (CT) combined with hysterosalpingography (HSG) revealed an iatrogenic diverticulum of the uterus. The three-dimensional CT combined with HSG images were very useful for subsequent surgery. A 37-year-old woman who wished to become pregnant presented to our hospital with genital bleeding during her periods after myomectomy had been performed at another institution. Ultrasound, magnetic resonance imaging (MRI) (Fig. 1), and hysterosalpingography (HSG) (Fig. 2) revealed an abnormal fluid-filled space (presumed to be a diverticulum) (1Rajiah P. Eastwood K.L. Gunn M.L. Dighe M. Uterine diverticulum.Obstet Gynecol. 2009; 113: 525-527PubMed Google Scholar, 2Umezaki I. Takagi K. Aiba M. Ohta H. Uterine cervical diverticulum resembling a degenerated leiomyoma.Obstet Gynecol. 2004; 103: 1130-1133Crossref PubMed Google Scholar) within the myometrium, which communicated with the uterine cavity.Figure 2Hysterosalpingography reveals left hydrosalpinx and occlusion of the right tube at its interstitial portion. The black and white arrows indicate the diverticulum and the uterine cavity, respectively.View Large Image Figure ViewerDownload Hi-res image Download (PPT) This diverticulum was presumed to have arisen secondary to rupture of the muscle layer sutures after myomectomy, which created a space that communicated with the uterine cavity. To correctly understand the spatial relationship between the uterine cavity and the diverticulum, three-dimensional reconstruction was done by the volume-rendering method using images obtained by combining 16-slice multidetector row computed tomography (CT) and HSG. The CT scanning was performed after intrauterine injection of water-soluble nonionic iodine containing contrast media diluted 20-fold, as is done for standard HSG, revealing a spherical diverticulum (2.5 cm in size) located to the left and anterior of the uterine cavity (Fig. 3). At operation, the myometrium directly above the diverticulum was incised to gain access to the lumen of the lesion, and then the walls of the diverticulum were resected. Next, the gap in the endometrium was closed and the myometrium was sutured to obliterate the space where the diverticulum had existed. In conclusion, both three-dimensional CT combined with HSG and MRI were useful for defining the anatomy of a secondary uterine diverticulum." @default.
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• W2080811081 date "2010-08-01" @default.
• W2080811081 modified "2023-09-23" @default.
• W2080811081 title "Three-dimensional computed tomography combined with hysterosalpingography is useful for both diagnosis and treatment of iatrogenic diverticulum of the uterus" @default.
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• W2080811081 doi "https://doi.org/10.1016/j.fertnstert.2010.01.007" @default.
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