Pelvic inflammatory disease with tubo-ovarian abscess and pyosalpinx

Case contributed by Mohammad A. ElBeialy

Presentation

Pelvic pain and colic for more than a year with recent onset of vaginal bleeding.

Patient Data

Age: 45 years
Gender: Female
  • right adnexal multilocular marginally enhancing cystic lesion is seen. 
    • the right fallopian tube is dilated, tortuous and distended with proteinaceous fluid. 
    • it shows dense peripheral enhancement. 
    • subacute blood is seen within it as a fluid level.
  • no solid adnexal masses
  • there is also a posterior uterine wall sub-serosal 3 cm fibroid.
  • no pelvic collection or enlarged lymphadenopathy.

DWI sequences can be helpful, showing diffusion restriction within the abscess as with elsewhere in the body.

Case Discussion

Diagnosis

Pelvic inflammatory disease (PID) with right tubo-ovarian abscess as well as extensive right pyosalpinx.

Incidental small sub-serosal fibroid.

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