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Type:
Educational Exhibit
Keywords:
Genital / Reproductive system female, Pelvis, Abdomen, CT, Ultrasound, Diagnostic procedure, Education and training, Pathology
Authors:
E. Matos, A. T. Almeida, D. Castelo; Vila Nova de Gaia/PT
DOI:
10.1594/ecr2015/C-2451
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 pathology affecting women,
particularly young women.
Other risk factors are low social status,
multiple sexual partners,
high coital frequency and the use of an intra-uterine device or other forms of pelvic instrumentation.
The latter gain special significance in older women.
Clinically,
it may be asymptomatic or manifest as a spectrum of signs and unspecific symptoms,
from vague constitutional symptoms to abdominal or pelvic pain,
vaginal discharge,
dyspareunia,
dysuria,
fever,
and others.
Due to the lack of specificity of these symptoms,
it can mimic other medical or chirurgical pathologies,
like acute appendicitis,
acute diverticulitis,
ileo-colitis,
ectopic pregnancy,
and others,
from which it must be differentiated.
Consequently,
and attending to the fact that laparoscopy,
the standard diagnostic technique,
being invasive and expansive,
is rarely done in this setting,
imaging methods come here particularly important,
and CT is often required in this scenario.
PID may lead to serious clinical consequences like infertility and ectopic pregnancy and is treatment with antibiotics. Surgery gains special importance when there are complications.