Kamla, a 30-yr-old lady examined for infertility by hysterosalpingography, reveals 'Bead - like' fallopian tube and clubbing of ampulla. The most likely cause is:
The following findings on hysterosalpingogram strongly suggest tubercular salpingitis:
• A rigid nonperistaltic pipe like tube, called lead pipe appearance
• Beading and variation in filling density
• Calcification of the tube
• Cornual block
• A jagged fluffiness of the tubal outline
• Vascular or lymphatic intravasation of the dye
• Tobacco-pouch appearance seen on naked eye examination.
Also Note:
• In a proven case of genital tuberculosis, hysterosalpingography is contraindicated as it may spread the infection.
• In TB Endometritis on HSG: The uterine cavity is shrivelled and obliterated by adhesions giving honeycomb appearance.
• On USG: Incomplete septation of the tubal wall “Cogwheel sign” is a marker for acute disease. Thin wall and beaded string appearance is a marker for chronic disease.
Gonococcus
Mycoplasma
Chlamydia
Mycobacterium tuberculosis