Adnexal Pathology

Question 1

• Inflammation of pelvic and adnexal structures
• M/C cause are STD’s
• Predisposes to infertility, tubal scarring & ectopics
• Occurs in 3 stages:
1. Early PID or endometritis
Sono: hyper endo, fluid in CDS, enlarged ovaries
2. Salpingitis w/ or w/o pus
Sono: pus in tube, cystic/ complex tubal or adnexal mass
3. Severe PID w/ tubo-ovarian abscess or pelvic peritonitis
Sono: large complex mass in adnexa, ↑ Doppler flow
• S/S: fever, ↑ WBC’s, abdomen/ pelvic pain, vaginal discharge or bleeding

Answer 1

PID pelvic inflammatory disease

Question 2

Collection of fluid within a scarred or obstructed Fallopian tube (pyo=pus)

Answer 2

Hydrosaplinx

Question 3

• Endometrial tissue outside the endo & myometrium
• Occur in women of reproductive age; anywhere in pelvis
• 2 forms:
o 1- Diffuse
Sono: rarely detected sonographically
o 2- Localized (ENDOMETRIOMA/ CHOCOLATE CYST)
Sono: well defined uni or multilocular cystic mass

•	S/S: Asymptomatic/ chronic pain , infertility
•	4 D’s of endometriosis
o	Dysmenorrhea- painful menses
o	Dyspareunia- painful intercourse
o	Dysuria- difficult urination
o	Dyschezia- difficult bowel movement

Answer 3

Endometriosis (BENIGN)