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September 19, 1977

Unusual Gas Shadow in Pelvis of Asymptomatic Patient

JAMA. 1977;238(12):1287-1288. doi:10.1001/jama.1977.03280130069024

History  A 47-year-old patient had anteroposterior and lateral films of the pelvis taken because of a minor injury to the left hip and knee.

Diagnosis  Transsexual pelvis.

Comment  A 47-year-old patient, originally a male, had had a transsexual conversion some years ago at another hospital. The anteroposterior roentgenogram of the pelvis (Fig 1) shows a typical normal male bony contour and structure (heavy bones and small pelvic cavity), with what appears to be a semiopaque speculum or obturator in the midline. The lateral view (Fig 2) locates this shadow not in the rectum but in the vagina. The patient then indicated that the shadow was that of a vaginal dilator, used frequently and over long periods to maintain patency in the surgically produced vagina. The dilator is a standard product produced by dealers in gynecologic material and measures about 13.34 cm in length and about 3.18 cm in diameter (Fig