Intravasation of water-soluble contrast agent into the internal iliac vein during hysterosaplingography

Intravasation of contrast agent during hysterosalpingography is a rare event. Most complications of hysteroscopy happen when oil-soluble contrast agent is used and the commonly reported cases are cramping lower abdominal pain, vaso-vagal attack, embolic phenomenon or uterine perforation. During the procedure of hysterosalpingography in a young woman with primary subfertility, using water-based, low osmolar contrast agent, intravasation of contrast into the parametrial vessels and internal iliac veins was noted. There was no major consequence except intense pain that was managed with analgesia and hours of observation. Although no major adverse reaction was noted yet safety profile of such type of contrast agent need to be evaluated further in controlled trials.