Inflammatory and infectious diseases

Abstract

Pelvic inflammation continues to pose a challenge because of diversity in clinical presentation, occurrence in up to 10% of women in fertile age, and resulting implications in public health in the acute setting and due to long-term sequelae (Livengood 2011). Pelvic inflammatory disease (PID) refers to infection of the upper genital tract due to ascension from the vagina, and is typically found in sexually active females. PID has to be discriminated from infections of the genital organs in the postpuerperal period and from hematogenous spread. Furthermore pelvic inflammation may result secondary to inflammatory pelvic processes including diverticulitis, appendicitis, Crohn's disease, and pelvic surgery. Although pain and tenderness are the most consistent clinical features, symptoms are often atypical, and in 20% of patients with PID, laboratory signs of inflammation or fever are missing (Quiroz 1999). The role of imaging in suspected pelvic inflammatory disease is to rule out non-gynecological causes of pelvic inflammation, to confirm the diagnosis of PID in advanced cases, particularly to diagnose tubo-ovarian abscess formation and its complications, and to perform abscess drainage.