Sexual Health |Bacterial STIs and related conditions | Acute Pelvic Pain and Sepsis

Acute Pelvic Pain and Sepsis
Session Overview
Description
This session covers the approach to specialist management of severe acute pelvic inflammatory disease (PID) and intra-abdominal sepsis. It includes in-patient investigations and laparoscopic findings.

Learning Objectives
By the end of this session you will be able to:

• Recognise severe acute PID and list criteria for in-patient admission
• Exclude other causes of acute abdominal pain in women by history, examination and appropriate investigations
• Describe basic resuscitation and support measures for a patient with intraabdominal sepsis pending admission
• Explain the role of laparoscopy in diagnosis
• Recommend appropriate parenteral anti-microbial regimens

Acute pelvic inflammatory disease (PID) describes a sudden or severe inflammation of the uterus, fallopian tubes, ovaries or surrounding areas in the lower abdomen (the adnexae). It is often caused by an ascending infection of the endocervix.

Chlamydia and gonorrhoea can cause PID. Recently, mycoplasma genitalium (MG) has also been identified as a possible cause. Other organisms commonly found in the vagina may also be implicated. However, often there are cases of PID where no pathogen is clearly identified.

PID is a common cause of morbidity and accounts for 1:60 GP consultations by women under 45 years of age [1](read details regarding the reference). If PID is not treated promptly it can cause long-term problems such as infertility, chronic pelvic pain and ectopic pregnancy.

Acute PID is not easy to diagnose since many of the symptoms can be caused by other conditions. However, since a delay of only a few days can lead to long-term sequelae, suspected acute PID should be treated before a positive diagnosis is made.