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US Hydro-Pyo-Hematosalpinx

Technique: Multiple transverse and longitudinal grayscale sonographic images were obtained of the pelvis. Color and duplex Doppler were performed in addition.
Findings:

The uterus is normal in size and shape for age and parity. The echogenicity of the uterine walls is normal and there are no uterine masses. The endometrial lining is of normal thickness.

There is a dilated, anechoic, elongated, tubular structure within the right adnexa which extends over to the left adnexa without evidence of internal flow on color Doppler, most consistent with a right hydrosalpinx.

The ovaries are visualized and appear normal bilaterally with normal flow and waveform analysis on color and duplex Doppler. There is no evidence of tubo-ovarian abscess. There is a small amount of free fluid within the cul-de-sac.


Measurements:
LMP: []
Uterus: [] cm
Endometrial stripe: [] mm
Right ovary: [] cm
Left ovary: [] cm

Impression:
1. Sonographic findings are most consistent with right hydrosalpinx. No evidence of active pyosalpinx or tubo-ovarian abscess as queried.
2. Small amount of free fluid in the cul-de-sac.

Follow-up


Findings: Again noted are markedly dilated anechoic tubular structures within the right and left hemipelvices felt to represent dilated fallopian tubes bilaterally. There has been interval development of low level echoes within the right fallopian tube as well as questionable associated mild wall thickening suggesting development of pyo- versus hematosalpinx. There is anechoic fluid seen within the left dilated fallopian tube. There does not appear to be the development of a heterogeneous mass to suggest interval abscess formation. There is no significant free fluid within the pelvis.

Both ovaries are identified as separate structures and demonstrate normal vascular flow with normal peripheral follicles. The left ovary measures [] cm, while the right ovary measures [] cm. The uterus is normal in appearance, shape and echogenicity. No uterine masses are identified. The endometrial stripe measures [] cm. The uterus measures [] cm.


Impression: Bilateral hydrosalpinx, right greater than left. There has been the interval development of low level echoes within the right fallopian tube with questionable mild associated wall thickening suggesting interval development of possible complex fluid, pyosalpinx, or hematosalpinx. There is no significant free fluid within the pelvic cul-de-sac. No findings to suggest the presence of interval abscess formation.