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Pelvic inflammatory disease and pyosalpinx

Case contributed by Tourisa Deilami
Diagnosis almost certain

Presentation

6 years history of infertility with severe RLQ pain, and tenderness.

Patient Data

Age: 30 years
Gender: Female

Transvaginal ultrasound

ultrasound

A right adnexal dead end, tubular, fluid filled structure, with typical mucosal infoldings toward the lumen, thick wall and a debris-fluid level (ultrasound image), characteristic of a dilated fallopian tube (in this case: pyosalpinx).

Right ovary is noted medial to the dilated fallopian tube and has normal appearance. Mild free fluid is noted in cul de sac and around the right adnexa.

No accompanying abscess was noted.

MRI confirmed ultrasound findings. The thick wall of the right fallopian tube is enhanced.

The debris-fluid level is best noted in sagittal T2 images.

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