IS Case 343: Pyosalpinx
2009 URMC Imaging Sciences
Publication Date: 2009-11-09
Patient is an 18-year-old female, G1P1 with a history of treated chlamydia, presenting with severe left lower quadrant pain and adnexal tenderness.
Transvaginal sonography recognizes the dilated fluid-filled fallopian tube by its tubular shape, somewhat folded configuration, and well-defined echogenic walls.
The dilated tube can be distinguished from a fluid-filled bowel loop by the lack of peristalsis. Low level internal echos may be seen within the fluid-filled tube as a result of pus (pyosalpinx), and a fluid-pus level may occasionally be seen.
Anechoic fluid within the tube indicates hydrosalpinx. A thickened tubal wall (5mm or more) is indicative of acute disease.
- Patel MD, Acord DL, Young SW. Likelihood ratio of sonographic findings in discriminating hydrosalpinx from other adnexal masses. AJR Am J Roentgenol. 2006 Apr;186(4):1033-8. PMID: 16554575