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Pelvic inflammatory disease - Management
What investigations and treatments are available in secondary care?
- In secondary care, investigations that might be considered to help make a diagnosis of pelvic inflammatory disease (PID) include:
- Transvaginal ultrasound scanning supported by power Doppler. This can identify inflamed and dilated tubes and tubo-ovarian masses, especially when there is diagnostic difficulty. However, similar changes may occur in endometriosis or early ectopic pregnancy.
- Magnetic resonance imaging and computerized tomography.
- Laparoscopy with direct visualization of the fallopian tubes. This is an invasive procedure and is not routinely used in clinical practice.
- Endometrial biopsy.
- Surgical management may include:
- Laparoscopy: division of adhesions and drainage of pelvic abscesses may help early resolution.
- Ultrasound-guided aspiration of pelvic fluid collections.
- Adhesiolysis if there is peri-hepatitis.
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