Pelvic inflammatory disease (PID) is an extremely broad term and essentially means is infection - inflammation of the upper female genital tract, resulting in a spectrum of abnormalities.
The highest incidence is seen among sexually active women in their teens, with 75% cases being under 25 years of age 7.
PID is defined as an acute clinical syndrome associated with ascending spread of micro-organisms, unrelated to pregnancy or surgery, from the vagina or cervix to the endometrium, fallopian tubes and / or contiguous structures.
It can result from number of causative organisms
- less common
Pelvic inflammatory disease is usually bilateral, except when it is caused by the direct extension of an adjacent inflammatory process such as appendiceal, diverticular, or post-surgical abscesses.
Imaging features often non-specific but are out of proportion to what may be apparent from symptomatology.
Ultrasound often only demonstrates ascitic fluid in the peritoneal cavity or, in the most severe cases, may show adnexal masses with a heterogeneous echopattern
Some sonographic signs associated with tubal inflammation include
CT shows diffusely enhancing ill-defined pelvic mass which may be difficult to differentiate from malignancy.
May show an ill-defined adnexal mass containing fluid with various signal intensity.
- T1 C+ (Gd) : the wall and the surrounding tissues may enhance.
Recognised complications of PID include
- tubo-ovarian abscess formation
- pyosalpinx formation
- adhesion formation with resultant bowel obstruction
- Fitz-Hugh-Curtis syndrome
- 1. Sam JW, Jacobs JE, Birnbaum BA. Spectrum of CT findings in acute pyogenic pelvic inflammatory disease. Radiographics. 22 (6): 1327-34. doi:10.1148/rg.226025062 - Pubmed citation
- 2. Tukeva TA, Aronen HJ, Karjalainen PT et-al. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology. 1999;210 (1): 209-16. Radiology (full text) - Pubmed citation
- 3. Rezvani M, Shaaban AM. Fallopian tube disease in the nonpregnant patient. Radiographics. 31 (2): 527-48. doi:10.1148/rg.312105090 - Pubmed citation
- 4. Horrow MM. Ultrasound of pelvic inflammatory disease. Ultrasound Q. 2004;20 (4): 171-9. Ultrasound Q (link) - Pubmed citation
- 5. Kaakaji Y, Nghiem HV, Nodell C et-al. Sonography of obstetric and gynecologic emergencies: Part II, Gynecologic emergencies. AJR Am J Roentgenol. 2000;174 (3): 651-6. AJR Am J Roentgenol (full text) - Pubmed citation
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- 7. Eurorad teaching files : Case 231
- 8. Eurorad teaching files : Case 1296
Synonyms & Alternative Spellings
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