Learning objectives
To describe and illustrate the spectrum of tomodensitometric (TDM) findings of pelvic inflammatory disease (PID).
It is important to be familiarized with these different possible findings - especially the early ones - not only to accurately differentiate this disease with others with overlapping features,
specifically in a clinical scenario of abdominal or pelvic pain in young women,
but also in making a correct diagnosis and,
consequently,
a timely treatment.
Background
Pelvic inflammatory disease (PID) is an infection of the superior genital female tract,
usually by an ascendant route.
Neisseria gonorrhoeae,
Chlamydia trachomatis and polymicrobial flora are the most frequent pathogens involved.
The infection gives rise to an inflammatory process involving the cervical canal,
uterine cavity,
fallopian tubes,
ovaries and pelvis.
It can also involve by contiguity or reactive inflammation adjacent abdomino-pelvic structures,
like the small and large bowel,
excretory renal system and the superior quadrant of the peritoneal surfaces (Fitz-Hugh-Curtis syndrome).
It is a frequent...
Findings and procedure details
The spectrum of ultrasonographic features is thoroughly known and amply described.
The opposite is seen with respect to TDM ones.
At an advanced and progressed staged of the disease TDM findings are easy to recognize and appear as tubo-ovarian and pelvic abscesses.
It is important to recognize the possible TDM findings of special significance,
mainly the early and subtle ones,
which frequently go unnoticed and unrecognized.
At an early stage of the disease these are reflected by edema with densification of the pelvic adipose planes,...
Conclusion
The spectrum of ultrasonographic findings of PID is well known and extensively described,
unlike the TDM findings.
The TDM evaluation is frequently sought in young women with PID,
according to the lack specificity of the clinical manifestations.
The need to achieve a correct diagnosis and a prompt and timely treatment is emphasized,
not only because is a frequent pathology that affects young women of childbearing years but also because it may have potentially serious complications.
Personal information
E.
Matos: MD Radiology resident at the Department of Radiology of Hospital Centre of Vila Nova de Gaia/Espinho.
Corresponding author:
[email protected]
A.
T.
Almeida: MD Radiology specialist at the Department of Radiology of Hospital Centre of Vila Nova de Gaia/Espinho.
D.
Castelo: MD Radiology resident at the Department of Radiology of Hospital Centre of Vila Nova de Gaia/Espinho.
References
Reviewed bibliography:
Sam J.
W.,
Jacobs J.
E.,
Birnbaum B.
A.
2002.
Spectrum of CT Findings in Acute Pyogenic Pelvic Inflammatory Disease.
RadioGraphics,
22:1327-1334.