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DOI:10.2214/AJR.07.2916
AJR 2008; 190:870-874
© American Roentgen Ray Society

Clinical Observations

Cesarean Section Scar Diverticulum: Appearance on Hysterosalpingography

Krishna Surapaneni1 and James E. Silberzweig2

1 Department of Radiology, Long Island College Hospital, Brooklyn, NY.
2 Department of Radiology, St. Luke's-Roosevelt Hospital Center, 1000 Tenth Ave., 4th Floor, New York, NY 10019.

OBJECTIVE. The purpose of this study was to characterize the frequency and appearance of hysterotomy defects on hysterosalpingography in patients with a history of cesarean section.

MATERIALS AND METHODS. We reviewed the hysterosalpingograms of 150 women with a history of cesarean section. The incidence, location, and appearance of defects at the expected location of a hysterotomy scar were evaluated.

RESULTS. Of the 148 patients with history of cesarean section and technically adequate hysterosalpingograms, 89 (60%) had defects that were in the expected location of a hysterotomy incision. Fifty-eight (65%) of the diverticula were focal outpouchings, and 31 (35%) were thin linear defects. Forty-eight (54%) of the diverticula were located at the lower uterine cavity, 32 (36%) at the uterine isthmus, and nine (10%) at the upper endocervical canal.

CONCLUSION. A diverticulum at the lower uterine cavity, uterine isthmus, or upper endocervical canal is a common finding on hysterosalpingography in patients with a history of cesarean section.

Keywords: cesarean section • hysterosalpingography


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