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Pelvic inflammatory disease

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

7 days of worsening lower abdominal pain and fever.

Patient Data

Age: 25 years
Gender: Female
ct
  • thickened and enhancing myometrium and cervical canal containing complex-appearing fluid
  • thickened right uterosacral ligament
  • Complex appearing pelvic free fluid extending anteriorly around the urinary bladder
  • dilated serpiginous structures in the bilateral adnexa consistent with pyo/hydrosalpinx
  • enlarged bilateral iliac, paracaval and para-aortic lymph nodes
  • enlarged bilateral inguinal lymph nodes, suggesting inflammation also involving the lower vagina

Findings on CT are most consistent with pelvic inflammatory disease.

Case Discussion

This case demonstrates the typical features of pelvic inflammatory disease (PID) on CT.

PID was confirmed upon vaginal speculum examination with tenderness to examination and pus expressing from the external cervical os. Swab cultures were positive for multiple microbes.

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