Pyosalpinx

Case contributed by Dr Ammar Haouimi

Presentation

Right pelvic pain and fever (temperature at 38.8 °C), leukocytosis at 12300 : mm3, CRP at 96 mg /L, ESR at 107 mm (1st hour)

Patient Data

Age: 60 years
Gender: Female
MRI

The right fallopian tube is distended and tortuous with fluid content of intermediate signal on T1WI, high signal on T2WI with rim enhancement on post-contrast sequences. DWI shows a high signal with corresponding low ADC, indicating a diffusion restriction. There is minimal peritoneal fluid in the pouch of Douglas.

Case Discussion

This case demonstrates the MRI features of pyosalpinx.

It should be differentiated from a simple hydrosalpinx by the presence of:

  • a thickened enhancing fallopian tube wall
  • surrounding inflammatory changes
  • restricted diffusion within the fallopian tube on DWI/ADC

The treatment is surgical.

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Case information

rID: 63475
Published: 18th Oct 2018
Last edited: 20th Oct 2018
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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