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Pelvic Inflammatory Disease (PID)

Ovaries-and-uterus on Fire
Picmonic
Pelvic inflammatory disease is a term used to describe infection leading to inflammation of the uterus, fallopian tubes and ovaries. This may lead to scar formation, adhesions to nearby organ systems, and infertility.
11 KEY FACTS
MECHANISM
Neisseria gonorrhoeae
Knives Gunner-ship

Neisseria gonorrhea is the most common cause of acute pelvic inflammatory disease in females. N. gonorrhea is a sexually transmitted disease responsible for causing purulent discharge.

Chlamydia Trachomatis
Chlamydia-clam

Chlamydia Trachomatis is a cause of subacute pelvic inflammatory disease, and can often go undiagnosed. C. Trachomatis is a sexually transmitted disease which can cause purulent discharge.

SYMPTOMS
Cervical Motion Tenderness
Cervix-Certificate Moving with Tenderizer

Cervical motion tenderness is a commonly seen symptom in women with PID. This symptom can also be related to painful sexual intercourse (dyspareunia).

Chandelier Sign
Hanging from Chandelier

"Chandelier Sign" is used to describe the severe pain in cervical motion tenderness seen in patients. This term is used because after testing for cervical motion tenderness, patients "jump up and off the bed and hang on to the chandelier."

Salpingitis
Sultan-in-flames

Salpingitis is described by infection and inflammation of the fallopian tubes. This is a complication of PID.

Tubo-ovarian abscess
Tuba-ovary abscess-guy

Complicated salpingitis may lead to tubo-ovarian abscess. This is a serious complication, leading to abscess in the fallopian tubes or ovary, and may lead to infertility.

Hydrosalpinx
Hydra-sultan

A hydrosalpinx is a distally blocked fallopian tube filled with serous or clear fluid. The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape. The condition is often bilateral and the affected tubes may reach several centimeters in diameter. The blocked tubes cause infertility.

COMPLICATIONS
Ectopic Pregnancy
Egg-top Pregnant-woman

An ectopic pregnancy occurs when an embryo implants somewhere other than the uterus, such as in one of the fallopian tubes. This can occur if the fallopian tubes are partially blocked, but an ovulated egg is still able to become fertilized. This is very painful for the female and is not a viable pregnancy.

Infertility
Infertile-female-plant

Obstruction of the fallopian tubes with salpingitis, hydrosalpinx, or tubo-ovarian abscess makes it much harder for an ovulated egg to make its way to the uterus. Often, with complicated PID, women become infertile.

Adhesions
Adhesive-tissue

Adhesions occur as inflammed ovarian, uterine or fallopian tissue begins epithelialization onto nearby structures. Often, adhesion occurs between the fallopian tubes and the uterine serosa, or to nearby organs, like the liver.

Fitz-Hugh-Curtis Syndrome
Fist-hit-curtain on liver

Fitz-Hugh-Curtis syndrome occurs when PID causes infection to spread to nearby organs. In this particular syndrome, the liver becomes inflamed and there is adhesions of the liver capsule to the peritoneum, which resembles "violin strings."

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