CASE REPORT: WHY DO HYPERSENSITIVITY REACTIONS OCCUR AFTER THE EXAMINATION OF HYSTEROSALPHYNGOGRAPHY?
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Anaphylactic reactions on non-vascular contrast examination, usually rarely cause hypersensitivity reactions. Administration of non-vascular contrast in several radiological examinations, including urethrography, retrograde pyelography, myelography, oral contrast, cholecystography, hysterosalfingography. This case report is a very rare case of hypersensitivity reactions i.e. face edema, angioedema, laryngeal edema post contrast in hysterosalpingography examination using ionic water-soluble contrast. A 32-year-old woman, shortly after hysterosalpingography examination experience swelling of the face, eyelids and respiratory tract accompanied by a little shortness of breath. Hysterosalpingography is an imaging method to evaluate the endometrial and uterine morphology and fallopian tube patency, by introducing a 10cc ionic water-soluble contrast into the uterine cavity via an external uterine ostium with falley catheter no.8. Vital signs and generalist status checks within normal limits. Results of examination of normal uterine cavity hysterosalfingography, both patent tubes. Contrast intravasation appears in the bilateral peri tubal and around the cavity uteri. Hypersensitivity reactions such as angioedema and facial swelling and edema larynx are systemic reactions that occur post non-vascular contrast giving on hysterosalfingography examination. Why this reaction can happen? This is due to the presence of intravasation of the ionic water-soluble contrast fluid passing through the vascular path of the uterine endometrium and peri tubal filling that progresses to the vascular (surrounding venous blood vessels). This contrast fluid systemically can cause hypersensitivity reactions from mild to moderate to severe levels. The prevalence of intravasation has been reported to be 0.4-6.9%