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Dan C. Martin, MD
Daniel Clyde Martin, M.D. (901) 347-8331 Updated information is
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False Cornual Occlusion False Cornual Blockage, Pseudo-Occlusion and / or Inadequate Filling of Tubes
Pseudo-occlusion, temporary occlusion and inadequate filling may describe the same HSG findings. This can occur due to spasm, infection, inadequate pressure, mucus in the tube and other causes. This may be a form of Cornual Occlusion or it may be inadequate filling. The first treatment is medical as covered in my 1990 paper - Therapeutic Implications of Diagnostic Hysteroscopy for Cornual Occlusion. It may also look like a hydrosalpinx.
These X-Rays are representative of the problem. The first of picture was taken before surgery and has dye trapped in the tubes.
The second X-ray after surgery, in the same patient, shows little dye in the left tube and none in the right tube. This suggests inadequate filling due to spasm, infection, or other causes.
Cornual and interstitial occlusion means the the tubes are blocked at the end near the uterus. This can occur because of infection, endometriosis, dried secretions in the tube, mucus in the tube, thick endometrium after day 10, scar and other causes. Rare causes are tubal pregnancy, healthy pregnancy and tubal tumor. In an infection is active, antibiotics can open the tubes. There is also an association of endometriosis with cornual occlusion. Hormonal suppression may help women with endometriosis. This may also be due to spasm as a reaction to X-ray dye or rapid injection. Inadequate pressure may result in incomplete filling. These may be corrected by medicine to relieve the spasm and/or by repeat hysterosalpingogram. Medicines have included anti-prostaglandins, belladonna alkaloids, and Glucagon. Examples of anti-prostaglandins include Aleve, Anaprox, Motrin, Advil, Torodol, Celebrex and Vioxx. Belladonna alkaloids include atropine and scopolamine (Hyocine butylbromide - Buscopan). Glucagon is a hormone that has a main purpose of maintaining the levels of blood sugar (glucose). Radiologists make decisions about Buscopan and Glucagon.
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