PELVIC INFLAMMATORY DISEASE PID is infection and inflammation of the female reproductive tract that occurs especially as a result of Sexually transmitted disease. It includes endometritis,parametritis,salpingitis Oophoritis,tubo - ovarian abscess and peritonitis The etiological agent most often is not identified, but common causative agents are Chlamydia trachomatis,Neisseria gonorrhoea,aerobic and anaerobic flora. SYMPTOMS. Lower abdominal pain Dyspareunia Fever Back pain and vomiting Abnormal vaginal discharge. Post coital bleeding or metrorrhagia Foul smelling vaginal discharge and pruritis DIAGNOSIS DIAGNOSIS OF PID IS A CLINICAL DIAGNOSIS. IT IS BASED ON SYMPTOMS AND SIGNS BIMANUAL AND SPECULUM EXAMINATION AND TESTING FOR CHLAMYDIA AND GONORRHOEA SHOULD BE PERFORMED IN ALL WOMEN WITH SYMPTOMS OF GENITAL TRACT INFECTION CDC DIAGNOSTIC CRITERIA FOR PID PID should be suspected and treatment initiated if Patient is at risk of PID And Patient has uterine,adnexal or cervical motion tenderness with no other apparent cause Findings that support the diagnosis Cervical /vaginal mucopurulent greenish /yellow discharge Elevated ESR or CRP Laboratory confirmation of neisseria /Chlamydia Fever Whit blood cells on vaginal secretion saline wet mount MOST SPECIFIC CRITERIA Endometritis on endometrial biopsy Laparoscopic abnormalities consistent with PID Thickened,fluid filled tubes apparent on TVS /MRI CLASSIC FINDINGS OF ACUTE PID ON TVS Tubal wall thickness >>5 mm Incomplete septae within the tube. Fluid in the cul - de - sac. Cog wheel sign ( cogwheel appearance of the fallopian tube on cross section seen in scan ) Tubo ovarian abscess CT FINDINGS IN PID Subtle changes in the appearance of pelvic floor fascial planes Thickened uterosacral ligaments Inflammatory changes of tubes or ovaries Abnormal fluid collection. With progress of disease,reactive inflammation of surrounding pelvic and abdominal organs is seen. MRI FINDINGS Tubo ovarian abscess Pyosalpinx Fluid filled fallopian tube Polycystic like ovaries with free pelvic fluid TREATMENT. ALL REGIMENS USED TO TREAT PID SHOULD ALSO BE EFFECTIVE AGAINST GONORRHOEA AND CHLAMYDIA AND ANAEROBES. Hospitalization is needed in Surgical emergencies Tubo ovarian abscess Pregnancy Severe illness with fever,nausea and vomiting. Unable to follow or tolerate OP oral regime No clinical response to oral anti microbial therapy.

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Essence of pelvic inflammatory disease by Dr.Madam Suvarchala Partap .Very useful for general practitioners and lady doctors who have never gone to the basics of Obstetrics and Gynaecology. Dr.Rajesh Gopal MBBS IMA PMC Reg no.35726.Ludhiana.
Thanks fr sharing mam. Very nice and helpful info.
Thank you for sharing useful information.
Very good information.thankyou
Good information .thanx
Thank u mam useful post
Excellant, Thanx.
Very good dr.
very nice
Madam ,Morning you agree with my answer on your post which still appears in my notification .But now I noted agree answer is not there .what is going on .Yes when I answered that your post is useful for those lady doctors who don't know basics of Obstetrics and Gynaecology ,I am absolutely right as come to rural areas ,floor cleaners in gynae hospitals are doing deliveries and put the word lady doctor in front of their name ,come Madam ,I will show you and even my request to Curofy team that they should verify a person's qualification and then should allow him or her your Curofy App . Dr.Rajesh Gopal .MBBS IMA PMC Reg no 35726 .Ludhiana .

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