{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:18:34Z","timestamp":1780661914522,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We present a case of diffuse skin immune reaction, diagnosed as cutaneous small\u2010vessel vasculitis, following assessment of tubal patency by contrast ultrasound, which appears to be the first reported case of hypersensitivity reaction to sonographic tubal patency testing, based on a literature search. A 32\u2010year\u2010old woman presented with non\u2010thrombocytopenic palpable purpura the day after assessment of tubal patency by two\u2010\/three\u2010dimensional hysterosalpingo\u2010foam sonography (HyFoSy) using ExEm\u00ae Foam. During real\u2010time ultrasound, the observer identified flow in only  the right tube when using saline with air as contrast medium; however, the same observer identified flow in both tubes after injecting ExEm Foam and the woman left the clinic without  any complications. The next day, the patient was admitted with a complaint of a red\u2010purple skin rash noticed the same morning, associated with moderate leg pain. Slow\u2010motion analysis of the recorded videos and three\u2010dimensional ultrasound datasets showed previously unnoticed venous intravasation of ExEm Foam into the myometrial vessels. Palpable purpura is typically found in vasculitis as a result of extravasation of red cells outside the inflamed blood vessel. This previously unreported side effect of tubal patency testing by HyFoSy, its potential rare organ consequences, as well as unknown consequences of venous intravasation by foam, should be included in the informed consent prior to the examination. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>","DOI":"10.1002\/uog.20372","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T15:18:35Z","timestamp":1561043915000},"page":"831-834","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cutaneous small\u2010vessel vasculitis following hysterosalpingo\u2010foam sonography (HyFoSy)"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-8661","authenticated-orcid":false,"given":"A.","family":"Ludwin","sequence":"first","affiliation":[{"name":"Department of Gynecology and Oncology Jagiellonian University Medical College  Krakow Poland"},{"name":"Ludwin &amp; Ludwin Gynecology Private Medical Center  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ludwin","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncology Jagiellonian University Medical College  Krakow Poland"},{"name":"Ludwin &amp; Ludwin Gynecology Private Medical Center  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Szczeklik","sequence":"additional","affiliation":[{"name":"Department of Medicine Jagiellonian University Medical College  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-5607","authenticated-orcid":false,"given":"W. P.","family":"Martins","sequence":"additional","affiliation":[{"name":"SEMEAR Fertilidade Reproductive Medicine  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18923"},{"key":"e_1_2_3_3_1","article-title":"Congenital Uterine Malformation by Experts (CUME): T\u2010shaped uterus","author":"Ludwin A","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15890"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.01.015"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2014.09.006"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40375"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu295"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140390"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17405"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/2156-7514.124105"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14914"},{"key":"e_1_2_3_13_1","first-page":"758","article-title":"Accuracy of hysterosalpingo\u2010foam sonography in comparison to hysterosalpingo\u2010contrast sonography with air\/saline and to laparoscopy with dye","volume":"32","author":"Ludwin I","year":"2017","journal-title":"Hum Reprod"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu024"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17420"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der367"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-120111"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12716"},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2014.07.015"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20372","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20372","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.20372","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T15:49:03Z","timestamp":1694015343000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1002\/uog.20372"],"URL":"https:\/\/doi.org\/10.1002\/uog.20372","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"2019-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}