Este documento describe varias posibles causas de dolor abdominal en una mujer joven, incluyendo piosalpinx, hidrosalpinx, absceso tuboovárico y síndrome de Fitz-Hugh-Curtis. También menciona enfermedad de Crohn, mucocele de apéndice, absceso de apéndice y otros quistes como posibles diagnósticos. Se proporciona información sobre el divertículo de Meckel, incluida su prevalencia, ubicación y síntomas comunes.
Lesion de aspecto quistico
Paredes bien definidas
Nivel liquido liquido, es decir , contenido denso con burbujas aereas
Lesión tubular
Contenido líquido
Acumulación de pus como resultado de una lalpingitis generalmente infecciosa,
Sintomas de sepsis, promiscuidad, DIU,
Corresponde a una fase crónica de la salpingitis.
Thick-walled fallopian tube
± Fluid distention (pyosalpinx), enlarged edematous ovaries, TOA/pelvic abscess, with inflammatory changes in pelvic fat and other pelvic structures, and free intrapelvic fluid
TVS and CT used for image-guided drainage of abscess
Advanced PID
Pyosalpinx
Greater degree of wall thickening and enhancement
Filled with complex fluid, fluid-debris level
Tubo-ovarian or pelvic abscess
Complex fluid collection ± internal septa
Thick-walled with ill-defined outer borders
Inner borders may be irregular
Presence of air uncommon
Involvement of adjacent structures
Small or large bowel ileus/obstruction
Thickening of small/large bowel wall or bladder wall
Ureteropelvicaliectasis (functional or mechanical obstruction)
Fitz-Hugh and Curtis syndrome (inflammation of right upper quadrant peritoneal surfaces, thick gallbladder wall, heterogeneous enhancement of liver)
Discontinuous asymmetric wall thickening > 1 cm
Minimal narrowing in acute or noncicatrizing phase
Soft tissue (ST) density inner ring (mucosa)
Low-density middle ring (submucosal edema/fat)
ST density outer ring (muscularis propria serosa)
Proliferation of mesenteric fat ± lymphadenopathy
"Target" or "double halo" sign
Intense enhancement of mucosa, muscularis propria
↓ attenuation in edematous thickened submucosa
Increased luminal narrowing; no "target" sign in chronic or cicatrizing phase
Mural stratification lost: Indistinct mucosa, submucosa, muscularis propria
Homogeneous attenuation of thickened bowel wall
Abscesses, fistulas, sinus tracts
Mesenteric changes: Abscess, fibrofatty areas, nodes
Perianal disease, enlarged mesenteric lymph nodes
"Comb" sign: Mesenteric hypervascularity (dilatation, tortuosity, wide spacing)
ST density inner ring (mucosa)
Imaging
Classified into 3 groups based on histology
Mucosal hyperplasia (simple mucocele)
Mucinous cystadenoma (most common)
Mucinous cystadenocarcinoma (↑ risk of perforation)
Pseudomyxoma peritonei
Due to rupture: Malignant > benign mucocele
Peritoneal cavity filled with mucus seedlings
Loculated ascites; scalloped surface of liver and spleen
Myxoglobulosis
Rare variant with multiple small globules ± calcifications
Mucocele
Calcification (curvilinear) within wall or lumen
Mucinous cystadenocarcinoma
Large irregular mass with thickened nodular wall
General Features
Best diagnostic clue: Round or oval, thin-walled, cystic mass near tip of cecum
Size: 3-6 cm in diameter
Other general features
Classified into 3 groups based on histology
Focal or diffuse mucosal hyperplasia
Mucinous cystadenoma
Mucinous cystadenocarcinoma
Focal or diffuse mucosal hyperplasia
Also called simple or retention mucocele
Resembles hyperplastic polyp of colon
Does not perforate
Mucinous cystadenoma
Benign neoplasm
Most common type of mucocele
20% of cases perforate with mucus seeding
Mucinous cystadenocarcinoma
1/5 as common as cystadenomas
↑ risk of perforation, forming peritoneal implants
Pseudomyxoma peritonei
Due to rupture: Malignant > benign mucocele
Peritoneal cavity filled with mucus seedlings
Myxoglobulosis
Rare variant with multiple small globules
Calcify & produce 1-10 mm mobile calcifications
Differentiate from phleboliths & calcified nodes
Previamente cirugias o proces inflamatorio que genera adhesiones.
Adyacente a los ovarios los cuales exudan normalmente fluidos los culaes se quedan atrapados en el lugar.