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Fallopian tubes allow the ovum to travel from the ovary to the uterus. They are 10-12cm in length and are situated in the superior aspect of the broad ligaments.
The Fallopian tubes vary in location within the pelvis and degree of tortuousity. They consist of cornual, isthmic and ampullary portions of fallopian tube().
HSG is the best method for evaluating and imaging the fallopian tubes. At HSG, the fallopian tubes should be identified as thin, smooth lines that widen at the ampullary portion Tubal abnormalities most commonly seen at HSG can be Spasm congenital due to spasm occlusion infection The cornual portion of the fallopian tube is surrounded by smooth muscle of the uterus. If there is spasm of the muscle during HSG the fallopian tube will not fill. This cannot be differentiated from tubal occlusion at HSG.
Antispasmodic agents (buscopan/glucagon) can relax smooth muscle and lead to fallopian tube opacification(, ).
It is important to differentiate between tubal occlusion and tubal spasm as the two entities can have very different impact on the patient’s fertility treatment.
Infection Pelvic inflammatory disease(PID) is the most common cause of tubal occlusion leading to infertility.
Tubal occlusion is seen as a cut-off of contrast material with nonopacification of the more distal fallopian tube. It can affect any portion of the fallopian tube and be unilateral or bilateral.