Pelvic Inflammatory Disease Flashcards
What is PID?
The result of infection ascending from the endocervix, causing endometritis, salpingitis, parametritis, oophoritis, tubo-ovarian abscess and/or pelvic peritonitis
Outline the pathophysiology of PID
Ascending infection from endocervix/vagina = inflam = damaged tubal ep = adhesions
What is endometriosis?
Appearance of endometrial tissue outside the uterus
What is salpingitis?
Inflam of fallopian tubes
Forms inflammatory exudate = fills tubes with pus = adhesions/fibres = blocks = forms abscess
What is a tubo-ovarian abscess?
Inflammatory mass involving the fallopian tube, ovary, occasionally adjacent pelvic organs
Late complications of PID
Can rupture and result in sepsis
Outline the aetiology of PID
Gonorrhoea
Chlamydia (doesn’t have a cell wall, so you cant gram stain it, detected by PCR)
Bacterial vaginosis
Copper coil = increased risk of introducing infection
What are the risk factors for PID?
Young age
Lack of barrier contraception
Multiple sexual partners
Low socioeconomic class
What clinical features are seen in a PID history?
Pyrexia
Pain = Lower abdominal pain, Deep dyspareunia
Abnormal vaginal/cervical discharge
Abnormal vaginal bleeding
Sexual history and prior STI
Contraceptive history
What clinical features are seen in a PID examination?
Fever
Low abdo tenderness
Bimanual examination = cervical motion tenderness
Speculum exam = low genital tract infection, discharge, cervicitis
Outline the investigations that should be performed for PID
Preg test
Endocervical/high vaginal swabs = diff locations of MOs
Blood tests = WBC, CRP
Screening for other STIs
Diagnostic laparoscopy
Ultrasounds scan
Outline the management of PID
Symptomatic treatment with analgesia and rest
Management of sepsis
Severe = IV Abx, possible surgical intervention (laparoscopy/laparotomy)
Contact tracing
What complications occur due to PID?
Ectopic preg
Infertility = due to scaring
Chronic pelvic pain = fixed retroverted uterus by scaring pulling it backwards
Fits-hugh-curtis syndrome = RUQ pain, adhesions between liver and diaphragm following chlamydial PID
Reiter syndrome = (cant see, cant pee, cant bend at the knee) disseminated chlamydial infection
What is endometritis?
Inflam and infection of the endometrium
