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    Pelvic Inflammatory Disease

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    ashleenriya832
    Pelvic inflammatory disease (PID) is an infection and inflammation of the female upper genital tract that is usually caused by sexually transmitted infections spreading from the cervix such as chlamydia or gonorrhea. Left untreated, PID can cause damage to reproductive organs leading to infertility or ectopic pregnancy. Symptoms include lower abdominal pain and abnormal vaginal discharge. Ultrasound is commonly used to image the inflamed and thickened reproductive organs and detect complications like tubo-ovarian abscesses. Prompt treatment with antibiotics is important to prevent long term complications.

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    Pelvic Inflammatory Disease

    Uploaded by

    ashleenriya832
    28 views15 pages
    Pelvic inflammatory disease (PID) is an infection and inflammation of the female upper genital tract that is usually caused by sexually transmitted infections spreading from the cervix such as chlamydia or gonorrhea. Left untreated, PID can cause damage to reproductive organs leading to infertility or ectopic pregnancy. Symptoms include lower abdominal pain and abnormal vaginal discharge. Ultrasound is commonly used to image the inflamed and thickened reproductive organs and detect complications like tubo-ovarian abscesses. Prompt treatment with antibiotics is important to prevent long term complications.

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    Pelvic inflammatory disease (PID) is an infection and inflammation of the female upper genital tract that is usually caused by sexually transmitted infections spreading from the cervix such as chlamydia or gonorrhea. Left untreated, PID can cause damage to reproductive organs leading to infertility or ectopic pregnancy. Symptoms include lower abdominal pain and abnormal vaginal discharge. Ultrasound is commonly used to image the inflamed and thickened reproductive organs and detect complications like tubo-ovarian abscesses. Prompt treatment with antibiotics is important to prevent long term complications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    28 views15 pages

    Pelvic Inflammatory Disease

    Uploaded by

    ashleenriya832
    Pelvic inflammatory disease (PID) is an infection and inflammation of the female upper genital tract that is usually caused by sexually transmitted infections spreading from the cervix such as chlamydia or gonorrhea. Left untreated, PID can cause damage to reproductive organs leading to infertility or ectopic pregnancy. Symptoms include lower abdominal pain and abnormal vaginal discharge. Ultrasound is commonly used to image the inflamed and thickened reproductive organs and detect complications like tubo-ovarian abscesses. Prompt treatment with antibiotics is important to prevent long term complications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    Pelvic

    inflammatory
    Disease
    Definition
    Pelvic inflammatory disease (PID) is an infection-related
    inflammation of the upper vaginal tract in women. The
    uterus, Fallopian tubes, and/or ovaries are all affected by
    the condition. It is usually an ascending infection that
    01. begins in the lower genital tract and spreads upward.

    PID can affect anyone but sexually active women in their


    20s are at higher risk of being affected.

    PID is treatable, however if left untreated it can cause


    severe damage to the reproductive system, infertility or
    ectopic pregnancy
    Etiology
    Sexually transmitted infections (STIs)are the most prevalent cause of PID
    • Chlamydia
    • Gonnerhea
    • Mycoplasma genitalium
    Other probable causes of PID
    • Ruptured appendix
    • Bowel infection (such as gastroenteritis)
    • Vaginal infection (such as bacterial vaginosis or BV)
    • some surgical procedures (such as dilatation and curettage (D&C),
    insertion of an intrauterine device (IUD) or surgical abortion).
    Clinical manifestations
    The medical and sexual history, as well as a gynecological examination, are used to determine
    the signs and symptoms of pelvic inflammatory disease. While it is possible to be
    asymptomatic, symptoms include:

    • Lower abdominal discomfort


    • Deep dyspareunia (painful sexual activity)
    • Menstrual irregularities (for example, menorrhagia, dysmenorrhea, or intermenstrual
    hemorrhage)
    • Bleeding after a sexual encounter
    • Painful urination (dysuria)
    • Abnormal vaginal discharge (particularly if purulent or odorous)

    Women with advanced instances may feel severe lower abdomen discomfort fever (>38° C),
    nausea, and vomiting. Tenderness of the uterus/adnexal or cervical excitement (on bimanual
    palpation) may be detected during a vaginal examination. There might be a palpable bulge in
    the lower abdomen, as well as an irregular vaginal discharge.
    Pathophysiology
    1. Sexually transmitted pathogens such as Chlamydia trachomatis
    or Neisseria gonorrhoeae infect the cervix.
    The vaginal flora in healthy females contains various potentially harmful
    bacteria, including Prevotella, Leptotrichia, Atopobium, and anaerobes.
    These bacteria exist in low numbers and can fluctuate due to factors like
    hormones, contraceptives, sexual activity, and hygiene practices.
    2. The pathogens disrupt the barrier provided by the endocervical
    canal.
    The endocervical canal(passageway from inside the uterus to the vagina)
    acts as a barrier, protecting the upper genital tract from vaginal bacteria.
    Infection with sexually transmitted pathogens can disrupt this barrier.
    3. Vaginal bacteria gain access to the upper genital organs.
    When the barrier is disrupted, vaginal bacteria can enter the upper genital organs,
    starting with the endometrium, then progressing to the endosalpinx(mucous
    membrane of the fallopian tube), ovaries, pelvic peritoneum, and underlying
    stroma.
    4. Ascending Infection
    Once the cervical barrier is compromised, bacteria can ascend into the upper
    genital organs. This typically starts with the endometrium (lining of the uterus) and
    can progress to involve the fallopian tubes, ovaries, pelvic peritoneum, and
    underlying tissues.
    5. Inflammatory Response
    As the bacteria ascend, they induce an inflammatory response. This leads to
    redness, swelling, and increased blood flow in the affected tissues.
    6. Specific Infections
    Endometritis: Infection of the endometrium. This can lead to symptoms like
    pelvic pain, abnormal bleeding, and fever.
    Salpingitis: Infection of the fallopian tubes. This is a crucial step, as it can lead
    to complications like tubal scarring, blockage, and ectopic pregnancy.
    Oophoritis: Infection of the ovaries. This can cause localized pain and
    tenderness.
    Imaging modalities
    Ultrasound – modality of choice
    The transabdominal approach best demonstrates the extent of the disease process, whereas the endovaginal
    approach is most sensitive for detecting dilated tubes, inflammatory changes, and abscesses. The fluid-filled
    urinary bladder provides an excellent acoustic window by displacing confusing loops of small bowel. Ultrasound
    demonstrates a thickened endometrium, possibly with irregularity that may contain fluid.
    CT
    may aid in assessing the full extent of the disease
    MRI
    unnecessary unless the patient has an iodine allergy
    Planar Radiography
    Plain abdominal or pelvic radiographs are of little value in detecting PID and pelvic abscesses. Abnormal gas
    collections can be masked by fecal material in the rectum and in loops of small bowel
    HGS
    This test should not be performed if you have pelvic inflammatory disease (PID) or have unexplained vaginal
    bleeding.
    Imaging appearance
    . Endometritis. Ultrasound image illustrates an
    enlarged endometrial cavity with a heterogeneous
    echogenicity (between cursors) associated with a
    therapeutic abortion

    Tubo-ovarian abscess. Ultrasound image


    demonstrates a large sonolucent mass (M)
    posterior to the bladder (B)
    Transabdominal ultrasound scan. This image demonstrates
    an echogenic region within the endometrium with dirty
    shadowing, a finding that is compatible with air in the
    endometrium and endometritis. Additionally, bilateral
    complex masses are present; this finding is compatible with
    tubo-ovarian masses.

    Endovaginal ultrasound scan. This image shows a relatively


    enlarged right ovary in a patient who had pain, increased
    flow, and a small amount of adjacent free fluid. These
    findings are compatible with oophoritis.
    Chronic pelvic inflammatory disease. Transverse sonogram
    demonstrates large, complex cystic and echogenic masses
    (arrows) posterior to the echo-free bladder
    CT
    Fluid in the endometrial cavity with pelvic fat
    stranding suggestive of endometritis

    Tubo-ovarian abscesses with inflammation extending


    along the right paracolic gutter up to the subhepatic
    region and presenting with right upper quadrant pain
    Loculated complex cystic lesion in the mid pelvis with folds and thick wall
    enhancement suggestive of pyosalpinx
    References

    Endosalpinx | definition of endosalpinx by Medical dictionary (thefreedictionary.com)


    Pelvic inflammatry disease: Pathogenesis, microbiology, and risk factors - UpToDate
    2017 European guideline for the management of pelvic inflammatory disease - PubMed
    (nih.gov)

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