Presentation
7 days of worsening lower abdominal pain and fever.
Patient Data
Age: 25 years
Gender: Female
From the case:
Pelvic inflammatory disease
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- 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.