Pyosalpinx

Pyosalpinx refers to a Fallopian tube that is filled, and often distended, with pus.

Pathology

A pyosalpinx often tends to be a complication of background pelvic inflammatory disease (PID). Inflammation results in tubal and peritubal adhesions with superimposed obstruction of the fimbrial end. Pyosalpinx can be a component of a tubo-ovarian abscess. Being unable to drain, the fallopian tube distends with pus, resulting in a pyosalpinx.

Radiographic features

A pyosalpinx may be seen as a thickened fallopian tube and may or may not be associated with debris. The Fallopian tube may be distended.

Ultrasound

• dilated serpentine/tubular structure in the pelvis
• low-level echoes due to the higher protein content of the debris within the tube distinguish a pyosalpinx from a hydrosalpinx

MRI

Morphological appearances of a pyosalpinx can sometimes be indistinct from simple uncomplicated tubal dilatation (hydrosalpinx) . As opposed to a simple hydrosalpinx, in pyosalpinx the tube wall may appear thickened  and have hyperenhancing tubal walls with surrounding inflammation.

Signal characteristics within the tubular lumen have been described as

• T1: variable due to varying protein content
• T2: often hyperintense, with characteristic amorphous shading
• T1 C+ (Gd): thick rim enhancement
• DWI/ADC: restricted diffusion in the fallopian tube

See also

• hydrosalpinx
• hematosalpinx

Siehe auch:

• Tuboovarialabszess
• Hydrosalpinx
• Unterleibsentzündung
• Eileiter
• haematosalpinx

und weiter:

• Tubenkarzinom
• peritoneal pseudocyst
• peritoneale Pseudozysten
• complicated hydrosalpinx