Spectrum of CT Findings in Acute Pyogenic Pelvic Inflammatory Disease

Abstract

Pelvic inflammatory disease (PID) is a common medical problem, affecting nearly 1 million women each year. Although the radiology literature is replete with discussions of the sonographic manifestations of PID, little has been published regarding the computed tomographic (CT) appearances of this entity. CT findings in early PID include obscuration of the normal pelvic floor fascial planes, thickening of the uterosacral ligaments, cervicitis, oophoritis, salpingitis, and accumulation of simple fluid in the endometrial canal, fallopian tubes, and pelvis. As the disease progresses, this simple fluid may become complex and the inflammatory changes may progress to frank tubo-ovarian or pelvic abscesses. Reactive inflammation of adjacent structures is common and can manifest as small or large bowel ileus or obstruction, hydroureter and hydronephrosis, right upper quadrant inflammation (Fitz-Hugh-Curtis syndrome), or peritonitis. Familiarity with the CT appearances of these manifestations is important for timely diagnosis and treatment of PID and its complications.

Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and 18F-FDG PET/CT

“…Tuberculous TOAs usually mimic peritoneal carcinomatosis from ovarian cancers [4]. The rectosigmoid colon and ureter are the most common organs that can be involved by TOA [21][22][23]. Rectal involvement was present in our case, which contributed to the suspicion of malignancy.…”

CT findings in acute peritonitis: a pattern-based approach

“…In women with PID, perihepatitis associated with right upper abdominal pain is known as Fitz-HughCurtis syndrome (9,10). It has been demonstrated that hepatic capsular enhancement implying perihepatitis can be present in women with PID without right upper abdominal pain (9,11).…”

Infección del tracto genital superior femenino: Revisión pictográfica por tomografía computada según clasificación clínica

“…Giancarlo Schiappacasse F (1) , Eric Gana G (2) , M. Ignacia Ríos P (2) , Pablo Soffia S (1) . reportes cerca del 39% de las pacientes afectadas por EIP correspondían a ATO la cual ha aumentado especialmente en mujeres mayores de 40 años (6) .…”

“…Corresponde a la infección y la inflamación resultante del tracto superior de los órganos reproductivos femeninos, incluyendo el endometrio, las trompas de Falopio y los ovarios (2) . Reportes de la literatura estiman que es una de las enfermedades más comunes del género femenino afectando 1 millón de mujeres, representando 275.000 hospitalizaciones al año en EE.UU (3,4) .…”