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Pyosalpinx

A pyosalpinx refers to a situation where the Fallopian tube becomes filled (and often distended) with pus.

Pathology

A pyosalpinx often tends to be a complication of background pelvic inflammatory disease (PID) where inflammation results in tubal and peritubal adhesions with superimposed obstruction of the fimbrial end. It can be a component of a tubo-ovarian abscess. Being unable to drain, the fallopian tube distends with pus resulting in a pyosalpinx.

Radiographic features

A pyosalpinx may be seen as a thickened fallopian tube and may or may not be associated with debris containing tubal distention.

Pelvic ultrasound

It may be seen seen as a dilated serpantine / tubular stucture in the pelvis. Low-level echoes are more commonly encountered in a pyosalpinx due to the higher protein content of the debris within the tube 4,6.

Pelvic MRI

Morphological appearances of a pyosalpinx can sometimes be be indistinct from a simple uncomplicated tubal dilatation (hydrosalpinx1. As opposed to a simple hydrosalpinx, the tube wall may appear thickened 3 and have hyper-enhancing tubal walls with surrounding inflammation.

Signal characteristics within the tubular lumen have been described as 5

  • T1 - variable due to varying protein content
  • T2 - often of high signal
  • T1 contrast - thick rim enhancement
  • DWI/ADC - avid internal diffusion restriction

See also

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