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Spectrum of CT Findings in Acute Pyogenic Pelvic Inflammatory Disease¹

¹ From the Department of Radiology, University of Pennsylvania Medical Center, Philadelphia. Presented as an education exhibit at the 2001 RSNA scientific assembly. Received March 21, 2002; revision requested April 26 and received July 17; accepted July 22. Address correspondence to J.E.J., Department of Radiology, NYU Medical Center, 560 First Ave, TCH HW205, New York, NY 10016 (e-mail: jill.jacobs@med.nyu.edu).

Pelvic inflammatory disease (PID) is a common medical problem, affecting nearly 1 million women each year. Although the radiology literature is replete with discussions of the sonographic manifestations of PID, little has been published regarding the computed tomographic (CT) appearances of this entity. CT findings in early PID include obscuration of the normal pelvic floor fascial planes, thickening of the uterosacral ligaments, cervicitis, oophoritis, salpingitis, and accumulation of simple fluid in the endometrial canal, fallopian tubes, and pelvis. As the disease progresses, this simple fluid may become complex and the inflammatory changes may progress to frank tubo-ovarian or pelvic abscesses. Reactive inflammation of adjacent structures is common and can manifest as small or large bowel ileus or obstruction, hydroureter and hydronephrosis, right upper quadrant inflammation (Fitz-Hugh-Curtis syndrome), or peritonitis. Familiarity with the CT appearances of these manifestations is important for timely diagnosis and treatment of PID and its complications.

© RSNA, 2002

Index Terms: Genitourinary system, CT, 85.1211 • Genitourinary system, diseases, 85.217 • Pelvic organs, diseases, 80.217 • Pelvic organs, inflammation, 80.217 • Peritoneum, CT, 791.1211, 791.295 • Peritonitis, 791.295

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