Transvaginal ultrasound of the pelvis may be useful where there is diagnostic difficulty. There are no features, however, which are pathognomonic of acute PID. Free fluid in the Pouch of Douglas is a common normal finding and is therefore not helpful. Scanning may help to exclude ectopic pregnancy, ovarian cysts or appendicitis and can also identify dilated fallopian tubes or a tubal abscess. More recent work with power Doppler has suggested that inflamed and dilated tubes and tubal ovarian masses can be diagnosed reasonably accurately. This investigation, however, requires considerable expertise and may not be readily available in an emergency setting. It therefore has very little benefit to the routine diagnosis of PID. Magnetic resonance imaging can assist in making the diagnosis where there is difficulty, but is also not widely available and certainly has not yet entered routine management. Computerized tomography (CT) scanning in acute PID may show obscuring of the pelvic fascial planes, thickening of the uterosacral ligaments and accumulation of fluid in the tubes and endometrial canal. In the upper abdomen it can provide evidence of peri-hepatitis. Enhancement of the hepatic and splenic capsules on abdominal CT scan has been suggested as characteristic of the Fitz-Hugh-Curtis syndrome but is of little value as a routine investigation.
Was this article helpful?
Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.