In genital tuberculosis, the organ MOST commonly involved and the characteristic pattern seen on hysterosalpingography is:
- A Fallopian tubes; pipe-stem appearance with terminal pouch ✓
- B Ovaries; bilateral cystic degeneration
- C Endometrium; filling defects and obliteration
- D Cervix; irregular stenosis
Correct answer: A. Fallopian tubes; pipe-stem appearance with terminal pouch
Explanation
The fallopian tube is the most commonly affected organ in female genital tuberculosis, occurring in >90% of cases. HSG characteristically shows a 'pipe-stem' (rigid, lead-pipe) appearance of the tubes, terminal pouch (blind-ending dilated fimbriae), and often bilateral cornual occlusion or calcifications. Endometrial TB is less common (50%) and causes Asherman-like adhesions. These HSG findings in a woman from a TB-endemic region should prompt evaluation for genital TB.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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