tuberculous pelvic inflammatory disease

Tuberculous pelvic inflammatory disease refers to pelvic inflammatory disease due to Mycobacterium tuberculosis.

Epidemiology

Genital tract involvement may be present in ~1.5% of cases of those affected with tuberculosis .

Pathology

Infection almost always results from spread from an extragenital source , usually from a haematogenous source or less commonly, via lymphatic vessels or from the peritoneal cavity.

Location

In the vast majority of cases, it involves the Fallopian tubes: tubal tuberculosis , Involvement is often bilateral .

Radiographic features

Hysterosalpingography (HSG)
  • tubal involvement:
    • obstruction of the Fallopian tube in the zone of transition between the isthmus and the ampulla
    • multiple constrictions along the course of the Fallopian tube (resulting in a beaded appearance to the tube)
  • endometrial involvement: features may vary; the spectrum according to one study was
    • normal uterine cavity: ~57% 
    • irregular cavity: ~18.5%
    • irregular filling defect: ~18.5%
    • uterine synechiae:  ~17%
    • shrunken cavity: ~3%
  • adnexal involvement
    • they may be calcified lymph nodes or smaller, irregular calcifications in the adnexal area
CT

Tuberculous pelvic inflammatory disease may be associated with

Treatment and prognosis

Complications

Differential diagnosis

For the hysterosalpingography appearance consider:

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