Case contributed by Dr Ian Bickle


Sexually active single female in her 20's with fever and lower abdominal pain.

Patient Data

Age: 25 years old
Gender: Female

Distended right fallopian tube with internal high T1 signal, rim enhancement and avid diffusion restriction.

The right ovary is cystic with high T2 signal, but no internal diffusion restriction.


Case Discussion

Pelvic inflammatory disease, pyosalpinx and tubo-ovarian abscess are all part of a spectrum of gynecological infection, related to sexually transmitted disease.

Usually the diagnosis is clinical, along with trans-vaginal ultrasound.  On occasion the patient may reach as far as MRI.

The fallopian tube is typically

- distended

- contained high T2 signal fluid, although this may vary

- thick enhancement of the wall of the fallopian tube

- avid internal diffusion restriction ( it is essentially a tube abscess so restricts like abscesses observed elsewhere ).

Treatment is surgical.

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Case information

rID: 29892
Published: 30th Jun 2014
Last edited: 14th Aug 2019
System: Gynaecology
Inclusion in quiz mode: Included

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