Background: Pelvic inflammatory disease (PID) is an acute infection of the upper female genital tract, which may involve the uterus, fallopian tubes and ovaries. Tubo-ovarian abscess (TOA) is a complication of Pelvic Inflammatory Disease. Different methods are being utilized to predict the failure of medical management of TOA. Neutrophil-lymphocyte ratio (NLR) has been proposed as a significant marker for diagnosis in PID. Objective: To compare NLR and sonographic TOA volume between patients who responded to medical management versus patients with failed medical management, and who eventually underwent surgery. Methods: This is a cross-sectional study done by reviewing the hospital records of patients admitted for TOA in a tertiary hospital, from 2014 to 2018. Demographic details of the patients, computed NLR values and TOA volumes were gathered and analyzed. Results: There was no statistical difference between the group who responded to treatment (medical group) versus the group of patients with failed medical management (surgical group) in terms of age, gravidity, parity and mean volume of the TOA. There was a statistically significant difference between the mean NLR of the two treatment groups. Conclusion Patients diagnosed with TOA, and with failed medical management have significantly higher levels of NLR compared with patients who responded to medical treatment. This positive association can be explored in future researches to validate NLR as a predictor of medical treatment failure for patients with TOA. NLR can also be potentially utilized as novel marker to indicate need for earlier surgical management to decrease the patient’s risk for sepsis.
Pelvic Inflammatory Disease

No abstract available.
Female ; Female* ; Humans ; Infertility* ; Pelvic Inflammatory Disease*

Aims: This study was designed to evaluate awareness and knowledge of pelvic inflammatory disease (PID), its risk factors and diagnostic procedures among female undergraduates in tertiary institutions in Rivers State, Nigeria. Methodology and results: A questionnaire-based survey design was conducted among 325 undergraduate students. Completed questionnaires were retrieved immediately. Descriptive and inferential (chi-square test) statistical tools were used for data analysis. Out of the 325 respondents, 186(57.2%) had heard of PID, 162(49.8%) did not know the possible risk factors of PID, 161(49.5%) perceived their awareness level of PID to be poor, while 30(9.2%) had good awareness level of PID. The majority 185(56.9%) of the respondents, do not know the mode of transmission of PID. There was a statistically significant relationship between the student’s age and the level of awareness statement at (p<0.05). On the student’s knowledge, only the statement: Do you know PID could be symptomless, showed a statistically significant relationship with the student’s course of study (χ2=12.815, p=0.00). Conclusion, significance and impact of study Most respondents have heard of PID via social media and seminars and have even seen those who had the disease. They still claim that their awareness level was poor since they do not know the mode of transmission and ill effects of PID, and so they cannot be protected against the disease. A sensitization campaign on risk factors, symptoms and mode of spread of the disease has to be carried out in the institutions to save the students at high risk of the infection.
Pelvic Inflammatory Disease ; Student Health Services

PURPOSE: To assess the sonographic evaluation of the appendix in patients with pelvic inflammatory disease (PID) using CT, clinical, and pathological comparisons. MATERIALS AND METHODS: During a three-year period, 51 patients with PID underwent appendix US and abdomino-pelvic CT. The findings of appendix on US were classified into three categories (normal appendix, normal appendix with inflamed periappendiceal fat, and acute appendicitis). Based on the CT analysis, the condition of the appendix was classified into five categories, namely ('normal, 'probably normal', 'equivocal CT findings for diagnosis of appendicitis', 'probable appendicitis', 'definite appendicitis'). The CT and US results were then correlate with clinical and pathological findings. RESULTS: Of 21 patients with definite or probable appendicitis as shown by CT analysis, US demonstrated normal appendix in 10 patients (48%), normal appendix with inflamed periappendiceal fat in 10 patients (48%), and primary appendicitis in the remaining patient (4%). Of 25 patients with normal or probably normal appendix as shown by CT analysis, US demonstrated normal appendix in 24 patients (96%), and primary appendicitis in the remaining patient (4%). The two patients with primary appendicitis, as shown by US, underwent appendectomy and pathological studies revealed primary appendicitis. CONCLUSION: A sonographic evaluation of the appendix in patients with PID improved the diagnostic accuracy for primary appendicitis.
Appendectomy ; Appendicitis ; Appendix ; Female ; Humans ; Pelvic Inflammatory Disease

We analysed the ultrasonographic findings in 46 cases of PID, examined atYyonsei Universtiy Severance Yondong Hospital from June 1983 to Dec. 1984. Among them, 29 cases of PID were well correlated with pathologic findings bysurgery or laparascopy. The results were as follows; 1. The age was ranged from 14 years to 57 years of age andthe majority was between 21 years and 50 years of age. 2. We evaluated the ultrasonographic findings of 46 casesunder the criteria of Swayne's classification. They are 67% in type II, 17% in type III and 4% in type I. Theremained is 11% in normal finding. 3. Among 29 cases pathologically proven,the ultrasonographic findings areclassifed to be 66% in type II, 21% in type III, 3% in type I and the remained is normal. Among type II PIDcases, tubo-ovarian abscess is 32%, pelvic abscess is 26% and pyosalphinx is 16%. The pelvic-peritoneal adhesionis demonstrated in 83% of 6 cases of type II lesion. 4. In 36 cases of PID, uterine mass formation is demonstrated and located unilaterally in 64%, associated fluid collection in 47% and bladder indentation in 36% was noted. The diameter of mass shadow is about 4.4cm of average, ranged between 2-9cm. The echogenecity was mixed in 64%, cysticin 31% and solid in 5% of mass lesion.
Abscess ; Classification ; Female ; Pelvic Inflammatory Disease ; Urinary Bladder

Female ; Humans ; Pelvic Inflammatory Disease/diagnosis* ; Intrauterine Devices

OBJECTIVE: To observe the effect of electroacupuncture (EA) on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease. METHODS: A total of 144 patients with chronic pelvic pain were randomly divided into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). The patients in the control group were treated with ibuprofen sustained-release capsules 10 days before menstruation, 0.3 g each time, once a day. On the basis of the treatment of the control group, the patients in the observation group were treated with EA at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), disperse-dense wave, 2 Hz/15 Hz of frequency, once a day. The patients in both groups were treated for 10 days per menstrual cycle for 3 menstrual cycles. The visual analogue scale (VAS) scores of lower abdomen and lumbosacral area, local sign score, quality of life scale score and pain disappearance rate were compared between the two groups before and after treatment. RESULTS: The VAS scores of lower abdomen and lumbosacral area as well as each item score and total score of local signs in the observation group after treatment were significantly lower than those before treatment and those in the control group ( CONCLUSION EA can relieve the pain symptoms in patients with chronic pelvic pain and improve their quality of life.
Acupuncture Points ; Analgesics ; Electroacupuncture ; Female ; Humans ; Pelvic Inflammatory Disease/therapy* ; Pelvic Pain/therapy* ; Quality of Life

Pelvic inflammatory disease (PID), the infection and inflammation of a woman's upper genital tract, is a frequent cause of infertility, ectopic pregnancy, and chronic pelvic pain among women of childbearing age. The management of PID has been largely based on the protocols issued by national or international institution. These guidelines recommended a broad-spectrum antibiotherapy in which quinolones continue to hold a key place. Yet, several significant facts such as the increase of quinolone-resistant gonococci and the emergence of 'new' pathogens have recently led us to reconsider the paradigms of the management of PID. This article reviewed lately published literatures on new bacteriological finding and recent antibiotics trials to delinate optimal regimen in managing PID.
Anti-Bacterial Agents ; Female ; Humans ; Hypogonadism ; Infertility ; Inflammation ; Mitochondrial Diseases ; Ophthalmoplegia ; Pelvic Inflammatory Disease ; Pelvic Pain ; Pregnancy ; Pregnancy, Ectopic ; Quinolones

Acute pelvic pain is one of the most common complaints of woman presenting in the emergency department. When gynecologic disorders are suspected, ultrasonography (US) is the modality of choice, enabling rapid diagnosis and decision making with regard to appropriate management. Frequent gynecologic etiologies include a large or enlarging simple ovarian cyst, hemorrhagic ovarian cyst or rupture of an ovarian cyst, acute pelvic inflammatory disease, and ovarian torsion. Endometriosis, uterine leiomyoma, and peritoneal inclusion cyst can also present as acute pelvic pain. Gynecologic disorders that cause acute pelvic pain frequently show characteristic ultrasonographic findings that enable specific diagnosis. In this review, the authors review ultrasonographic findings of gynecologic causes of acute pelvic pain.
Decision Making ; Diagnosis ; Emergency Service, Hospital ; Endometriosis ; Female ; Gynecology ; Humans ; Leiomyoma ; Ovarian Cysts ; Pelvic Inflammatory Disease ; Pelvic Pain* ; Rupture ; Ultrasonography*

PURPOSE: The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role. MATERIALS AND METHODS: We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID; n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups. RESULTS: We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women; HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed. CONCLUSION: The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems.
Abdomen ; Abscess ; Adipose Tissue ; Diagnosis, Differential ; Fallopian Tubes ; Female ; Humans ; Pelvic Inflammatory Disease ; Pelvic Pain ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Rupture