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Pyosalpinx

Pyosalpinx refers to a Fallopian tube that is filled, and often distended, with pus.

Pathology

A pyosalpinx often tends to be a complication of background pelvic inflammatory disease (PID). Inflammation results in tubal and peritubal adhesions with superimposed obstruction of the fimbrial end. Pyosalpinx 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. The Fallopian tube may be distended.

Pelvic ultrasound
  • dilated serpentine/tubular structure in the pelvis
  • low-level echoes due to the higher protein content of the debris within the tube distinguish a pyosalpinx from a hydrosalpinx 4,6
Pelvic MRI

Morphological appearances of a pyosalpinx can sometimes be be indistinct from simple uncomplicated tubal dilatation (hydrosalpinx1. As opposed to a simple hydrosalpinx, in pyosalpinx the tube wall may appear thickened 3 and have hyperenhancing 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 hyperintense
  • T1 C+ (Gd): thick rim enhancement
  • DWI/ADC: restricted diffusion in the fallopian tube

See also


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