Pelvic Inflammatory Disease (PID)

Symptoms

A 21 year old woman presented with severe lower pelvic pains. There was no cyclical pattern to the pain. She had taken several courses of antibiotics following review in the Emergency Department.

Diagnosis

Pelvic ultrasound was normal. Laparoscopy revealed evidence of Pelvic Inflammatory Disease (PID).

Procedure

The filmy adhesions were divided. Peritoneal swabs did not reveal any organisms. The most common organisms are Chlamydia and Gonorrhoea. These were presumably treated by courses of empiric antibiotics. PID is a relative contra-indication to an IUCD (such as Mirena). It can cause tubal damage and lead to infertility and increased risk of ectopic pregnancies.

The pelvis at laparoscopy.

Filmy adhesions involving the right Fallopian Tube.

Filmy adhesions involving the right ovary.

Division of adhesions.

Division of adhesions.

The pelvis at the end of the procedure.