CH. 45 Adnexa Path Flashcards
What does PID stand for?
Pelvic Inflammatory disease
PID is most commonly associated with..?
STDs (gonorrhea and Chlamydia)
what are some less common causes of PID?
- ruptured appendix
- post surgical infection
- appendicitis
is PID unilateral or bilateral?
bilateral usually
what are the long-term consequences of PID?
pelvic pain, infertility, increased risk of ectopic pregnancy
what are the risk factors for PID?
- early sexual contact
- multiple sexual partners
- History of STDs
- douching
what is endometritis?
inflammation of endometrium
what is salpingitis?
inflammation of fallopian tubes
what is hydrosalpinx?
fallopian tube is blocked by fluid
what is pyosalpinx?
fallopian tubes filled with pus
what is periovarian inflammation?
infection or inflammation that has spread to the fallopian tube, ovary and broad ligament
what is a Tubo-Ovarian Abscess? (TOA)
infection of a pocket of pus that forms in the fallopian tube and ovary, involving the broad ligament
what is peritonitis?
inflammation of the peritoneum
how does PID spread?
spreads along the mucosa of pelvic organs
where does PID infect first?
cervix
how does PID progress from the Cervix?
the endometrium, then fallopian tubes, ovaries, and finally the peritoneum
what are the clinical signs for PID?
- pelvic pain
- fever
- vaginal discharge
- increased WBC count
How does PID appear on ultrasound?
- fluid/ pus in the posterior cul-de-sac
- thickened endo
- fluid in fallopian tubes
- complex abscess
what are the stages of PID?
1) endometritis
2) salpingitis
3) severe PID in broad ligament and ovarian involvement
4) chronic long-standing PID
what are the clinical signs for salpingitis?
- asymptomatic pelvic discomfort
- low-grade fever
how does salpingitis appear on ultrasound?
- dilated tubes
- tortuous tubes
define TOA
tubo-ovarian abscess, this is where adhesions cause the ovary to be stuck to the fallopian tube &/or the broad ligament, leaving scars
define peritonitis
inflammation of the peritoneum and the serous membrane lining of the abdominal cavity.
list several causes for peritonitis
when infectious process spreads OUTSIDE the pelvis; ovaries and tubes to involve bladder, ureter, bowel, and adnexal area.
what is the sonographic appearance of peritonitis?
- gas forming bubbles
- loculated areas of fluid
what is the most common cause of endometritis in a non-OB patient?
STDs
what is the most common cause of fever after delivery?
c-section endometritis
what is the ultrasound appearance of endometritis?
- endo >20mm
- thick endo
- fluid, air, clot in the endo
what is endometriosis?
fuctional endometrial tissue in abnormal locations
what are the symptoms of endometriosis?
- dysmenorrhea
- pelvic pain
How does endometriosis appear on ultrasound?
- hypoechoic
- ill-defined borders
- ground glass (endometrioma)
what is a chocolate cyst?
endometrioma
what are the two main reasons for ultrasound intervention with PID?
- biopsy and access abscess drainage
- evaluate post-op pelvic masses
