title: [Adnexal defect identified with hysterosalpingogram and laparoscopy during infertility evaluation].
abstract: OBJECTIVE
  To describe a previously unreported adnexal defect as a cause of an abnormal hysterosalpingogram (HSG), identified during infertility evaluation.
  
  
  METHODS
  An abnormal hysterosalpingogram (HSG) consistent with partial left tubal obstruction or hydrosalpynx was identified during the evaluation of a 33 year-old nulligravida with no prior surgical history. At laparoscopy, the diagnosis was revised when a approximately 3x4cm regular, ovoid, physiologic aperture was noted in the central aspect of the left broad ligament in the region corresponding to the HSG defect. The lesion was explored but not repaired. Bilateral tubal patency was confirmed via indigo carmine chromopertubation.
  
  
  RESULTS
  Ovulation induction and intrauterine insemination were undertaken based on findings at surgery and careful discussion of same with the couple. The patient successfully conceived and had a normal term delivery.
  
  
  CONCLUSIONS
  While HSG abnormalities discovered during infertility assessment are not unusual, intrinsic or de novo peritoneal defects have not been described previously. Abnormal radiographic findings may be explained by this lesion in selected cases.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, Atlanta Medical Center, Atlanta, Georgia, Etats-Unis. dr.sills@ivf.com
authors.forename: E-S
authors.initials: ES
authors.lastname: Sills
authors.forename: M
authors.initials: M
authors.lastname: Perloe
authors.forename: D-P
authors.initials: DP
authors.lastname: Levy
authors.forename: G-D
authors.initials: GD
authors.lastname: Palermo
mesh_terms: D000328:Adult; D001956:Broad Ligament / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology; D010535:Laparoscopy; D016896:Treatment Outcome