This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.

1. University of Sulaimani
Faculty of Medical Sciences
School of Medicine

2. Infertility (tubal patency , Asherman′s syndrome).
congenital uterine anomalies.
Recurrent miscarriage.
Abnormal uterine bleeding.
Diagnosis of uterine mass (fibroids).
Evaluation following pelvic trauma.

3. Pain (because of dilatation of uterus , spillage into peritonium).
Bleeding.
Intravasation(secreted by kidney causing obscure fallopian
tube)
Vasovagal episode.
Infection (pelvic).
Pregnancy irradiation.
Allergic reaction (to iodinated contrast media).
Failure.

4. Pregnancy.
Bleeding.
Immediate premenstrual or postmenstrual phase.
Recent untreated pelvic infection.
Tubal or uterine surgery within last 6 weeks.
Contrast medium sensitivity.

5. Volsellum Higar dilator
Speculum Screw cannula Contrast media
Timing : should be performed within 10th-14th day of cycle .

6. 1-Long thin tubal outline.
2-ill defined peritoneal spillage.
3-Anteverted triangular uterus,
Normal size : 2.5 – 5 cm.
1
3
2
 Diagnosis: normal film.
 Description: small uterus (nulliparous)

7. 1-Long thin tubal outline.
2-ill defined peritoneal spillage.
3-Anteverted triangular uterus.
1
3
2
 Diagnosis: normal film.
 Description: large uterus (multiparous)

8.  Diagnosis: amenorrhoea due to adhesion.
 Description: uterus is smaller than normal

9.  Diagnosis: infantile uterus.
 Description: uterus is smaller than normal.

10.  Diagnosis: normal film.
 Description: very large uterus.

11.  Diagnosis: retroverted uterus.
 Description: deviation from medline.

12.  Diagnosis: retroverted uterus.
 Description: deviation from medline.

13.  Diagnosis: arcuate uterus.
 Description: partial separation (forming right angle).

14.  Diagnosis: arcuate uterus.
 Description: partial separation (forming right angle).

15.  Diagnosis: unicornuate uterus.
 Description: one cornua , one tube , one spillage.

16.  Diagnosis: unicornuate uterus.
 Description: one cornua , one tube , one spillage.

17.  Diagnosis: bicornuate uterus.
 Description: complete separation (forming open angle).

18.  Diagnosis: bicornuate uterus.
 Description: complete separation (forming open angle).

19.  Diagnosis: bicornuate uterus.
 Description: complete separation (forming open angle).

20.  Diagnosis: bicornuate uterus.
 Description: large right side containing fetus (miscarriage).

21.  Diagnosis: complete didelphys uterus.
 Description: two cervix , two uterus (look for two cannula!)

23.  Diagnosis: septate uterus.
 Description: slight separation (forming acute angle).

24.  Diagnosis: septate uterus.
 Description: slight separation (forming acute angle).

25.  Diagnosis: septate uterus.
 Description: slight separation (forming acute angle).

26.  Diagnosis: bicornuate uterus with filling defects.
 Description: differential diagnosis: fibroids , air bubbles , bowel gas.

27.  Diagnosis: bicornuate uterus with filling defects.
 Description: differential diagnosis: fibroids , air bubbles , bowel gas.

28.  Diagnosis: bilateral hydrosalpinges with patent fallopian tube.
 Description: dilatation of tubes.

29.  Diagnosis: bilateral hydrosalpinges with patent fallopian tube.
 Description: saccular dilatation of tubes.

30.  Diagnosis: uterine fibroid.
 Description: large, Irregular outline uterus with filling defect.

31.  Diagnosis: uterine fibroid.
 Description: large, Irregular outline uterus with multiple filling defects.

32.  Diagnosis: Hydrosalpinx.
 Description: take different size and shape of dilatation (sacculation).

33.  Diagnosis: uterine fibroids.
 Description: constant filling defect (immobile).

34.  Diagnosis: uterine fibroids.
 Description: constant filling defect (immobile).

35.  Diagnosis: uterine fibroids.
 Description: constant filling defects (immobile).

36.  Diagnosis: adenomyosis.
 Description: irregular outline, multiple diverticulum..

37.  Diagnosis: small narrow uterus.
 Description: differential diagnosis : Asherman ,DC, TB uterus.

38.  Diagnosis: small narrow uterus.
 Description: differential diagnosis : Asherman ,DC, TB uterus.

39.  Diagnosis: small narrow uterus.
 Description: differential diagnosis : Asherman , DC,TB uterus.

40.  Diagnosis: fallopian tube ligation.
 Description: absent uterine tube at both sides.

41.  Diagnosis: intravasation of contrast.
 Description: contrast intered ureter.

42.  Diagnosis: intravasation of contrast.
 Description: contrast intered ureter.

43.  Diagnosis: intravasation of contrast.
 Description: contrast intered ureter.

45. Body
Head
 Diagnosis: cephalic presentation.
 Description: plain x-ray taken for pregnant lady( for lie , presentation)

46. Head
Body
 Diagnosis: breech presentation.
 Description: plain x-ray taken for pregnant lady( for lie , presentation)

47.  Diagnosis: Dermoid.
 Description: tooth inside uterus.

48.  Diagnosis: IUCD.
 Description: copper IUCD inside uterus.

49.  Diagnosis: IUCD.
 Description: copper IUCD outside uterus (missed).

50.  Diagnosis: uterine fibroid.
 Description: calcification inside uterus.

51.  Diagnosis: uterine fibroid.
 Description: calcification inside uterus.