Morita A, Kakinuma T, Segawa A, Harada S, Takae S, Tamura M, Suzuki N. Prolonged retention of oil-based iodinated contrast medium observed on plain abdominal radiograph after cesarean section: A case report. World J Clin Cases 2025; 13(29): 110454 [DOI: 10.12998/wjcc.v13.i29.110454]
Corresponding Author of This Article
Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Yokohama 2410811, Kanagawa, Japan. kakinuma@marianna-u.ac.jp
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Akari Morita, Toshiyuki Kakinuma, Arimi Segawa, Satoshi Harada, Midori Tamura, Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama 2410811, Kanagawa, Japan
Seido Takae, Nao Suzuki, Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki 2168511, Kanagawa, Japan
Author contributions: Morita A, Kakinuma T, Segawa A, Harada S, Takae S, Tamura M, and Suzuki N contributed to data analysis; Morita A and Kakinuma T contributed to manuscript writing and editing; Kakinuma T contributed to conceptualization and supervision. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Yokohama 2410811, Kanagawa, Japan. kakinuma@marianna-u.ac.jp
Received: June 9, 2025 Revised: June 27, 2025 Accepted: July 24, 2025 Published online: October 16, 2025 Processing time: 82 Days and 19.8 Hours
Abstract
BACKGROUND
Oil-based iodinated contrast media have excellent contrast properties and are widely used for hysterosalpingographic evaluation of female infertility. On abdominal radiography and computed tomography (CT) scans, their radiodensity is similar to that of metallic objects, which can sometimes lead to diagnostic confusion in the postoperative settings. In this case, retained oil-based contrast medium was observed on an abdominal radiograph following a cesarean section, making it difficult to differentiate from an intraperitoneal foreign body from surgery.
CASE SUMMARY
The patient was a 37-year-old pregnant woman who was referred to our hospital at 32 weeks and 1 day of pregnancy due to complete placenta previa for management of pregnancy and delivery. An elective cesarean section was performed at 37 weeks and 3 days. A plain abdominal radiograph taken immediately after surgery revealed a near-round, hyperdense, mass-like shadow with a regular margin in the pelvic cavity. An intraperitoneal foreign body was suspected; therefore, an abdominal CT scan was performed. The foreign body was located on the left side of the pouch of Douglas and had a CT value of 7000 Hounsfield units, similar to that of metals. The CT value strongly suggested the presence of an artificial object. However, further inquiries with the patient and her previous physician revealed a history of hysterosalpingography. Accordingly, retained oil-based iodinated contrast medium was suspected, and observation of the object’s course was adopted.
CONCLUSION
When intraperitoneal foreign bodies are suspected on postoperative radiographs, the possibility of oil-based iodinated contrast medium retention should be considered.
Core Tip: Iodine oil contrast agents have good contrast properties and are widely used in hysterosalpingography for evaluation of infertility. However, due to their slow absorption, they can remain in the body for an extended period. Therefore, when a postoperative plain abdominal X-ray reveals a suspected intraperitoneal foreign body, it is important to consider the possibility of residual iodine oil contrast agent when providing treatment.
