It is an inflammation of upper genital tract involving the fallopion tubes as well as the ovaries.

1. Sexually transmitted disease: gonococcal n chlamydial infection r most common. They traval with motile sperm in piggy back fashion n reach fallopion tubes n causes salpingo oopharitus.
2. Other organism causing PID
 ¡. Mycoplasm
 ¡¡. E. Coli
 ¡¡¡. Viruses
 ¡V. Tubesculi bacili
3. Post obortal n puerpural sepsis
4. Minor operative procedure like D/C n hysterosalpigogram manual removal of placenta n evacuation of products of conception.
5. Introduction of IUCD incidence of PID
6. Pelvic peritonits
7. Tuberculosis is blood borne.

-it is disease of sexuly active women, reproductively active n frequent changes of sexul parters is cause in devloped countries.
-In developing countries puerperal sepsis n septic obortions are imp. Cause.

1. Acute salpingitis: fallopion tube is swollen, odematous n hxeramic wit visible,dilated vessles on the peritonial surface.
-dicharge of seropurulunt fluid from the fimbrial end of the tube.
-mucous memb. Is edematous wit infiltration of the leucocyte n plasma cells.
2. In ascending inf. Like gonorrohea.
-mucous memb. 1st to get invove.
-inflamatory exudate is discharge into lumen wich drain at ampullary end.
-ulceration lead to adhesion n tubal blockge or narrowing of lumen.
-pus in the pelvic cavity through fimbrial end causes pelivic abscess.
-wall of the tube is thickend n tense.
3. PID Following post bact. n puepural inf.
-inf. Spread through cervix via lymphatics to cellur tissue in the broad lig. Couses cellulitis.
-wall is thickended.

1. stage ¡: Acute salpingitis witout peritonitis
2 stage ¡¡:Acute salpingitis with peritonitis
3 stage ¡¡¡: Acute salpingitis with superimposed tubal oclusion or tubo ovarian complex.
4 stage ¡v :rupture tubo ovarian abscess
5 stage v: tubercular salpingitis.

Young, sexully active women is prone to PID
1 ABODMINAL PAIN which ir bilatral, rertricted to lower abdomen sever in acute stage with fever
2 dysuria
3 vagimal discharge
4 uterine bleeding
5 fever, diarrhoea in case of pelvic abscess.

1 high temp n toxic look
2 tachycardia
3 tongue shows sings of dehydration
4 abdo. Distended, tender
5 speculun exm^ shows purulen discharge
6 cervicl movement r tender
7 pelvic abscess- floctuating tender swelling in pouch of douglus.

1 acute appendisits- temp. Is not high as in PID., no vaginal discharge, irregularities in mc
2 ectopic gastation-vaginal discharge, leucocytosis, rised esr is absent.
3 diverticulosis
4 twist overian cyst-pyrexia abscent. Vaginal discharge abscent.
5 rupture endometral cyst
6 septic abortion.

1 Hb, Tcl, ESR
2 Cervical n high vaginal swab culture.
3 blood culture
5 blood urea n serum electolytes
6 culdountrsis

1 MILD treat at home wit antibiotics.
2 MODERATE-SEVER -hospitalization
-medical treatment with antibiotics
tetracycline 500mg q.i.d x 10days
doxycline 100mg b.d x 10days
erxthromycin 500mg q.i.d x 7 days

minimal invasive surgery includes
1 laproscopic drainage of tubo ovrian absbess
2 ultrasound guided aspiration of pelvic absess
3 precutaneous absesr drainge

1 recurrence
2 chronic PID
3 Tubal blockege
4 pelvic pain

failure of acute pelvic infection to resolve result in chronic tubovarian masses. Thes manifaest in the form of
  chronic pyosalpinx
  chronic interstitiaj salpingitis
  tuboovaria cyst
  tuberculous form
1 Constant low abdominal pain which worse before mc
2 vaginal discharge may absent
3 menorrhagia, polymenorrhagia, n congestive dymenorrhoea.
4 infertility may due to blockage of fallopian tube.
5 rectal irritation
1 in pelvic exam^ shows apendages r found to b tender, thickended n fixed
2 uterus n appendages are densely adhernt to echa other.
1 ectopic gestation
2 uterine firoboids
3pelvic endometiosis
4 ovarian tumour
5 tubercular tubo ovarian mass
IT need surgicl treatment
1 in young women conservativi surgery in form of salpingectomy n salpingo oophorectomy is performed.
2 in extensive damage abdominal hysterectomy wit bilatral salpingo oopherectomy is needed.
3 tuboplasty it require in tubal blockage. Laparoscopic breaking of external adhesion either by laser or electrocoutery is indicated if the tubal blocge is due to ext. Adhesions.
Hystoscopic balloonoplasty.

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