Pelvic Inflammatory Disease

00:01 Our topic now brings us to the convergence point of pelvic inflammatory disease.

00:06 It’s characterized by the following: You want to know these.

00:10 Pelvic pain, adnexal tenderness.

00:12 What’s meant by adnexal tenderness? Adnexa means those organs that are close to or next to what you’re trying to feel or palpate.

00:24 So if you’re down at the pelvic region and you’re referring to the adnexal tenderness, we’re referring to the ovaries.

00:31 Fever and vaginal discharge, part of PID.

00:35 Usual suspects, Chlamydia, trachomatis D through K, Neisseria gonorrhea.

00:41 It can also be polymicrobial with enteric bacteria, usually after an abortion or delivery, look for that.

00:47 And bacteria spreads from the uterus upward via lymphatics or the veins, resulting in PID.

00:56 What are my complications? You may result in peritonitis, intestinal obstruction due to adhesions, why? So you're going to now group together for me -- Earlier, I walked you through ectopic pregnancy and pelvic inflammatory disease.

01:12 Why? Whenever there’s inflammatory process or lesion or whatever, then it’s soon to be followed by repair and collagen and fibrosis, right? Fibrosis in the fallopian tube then predisposes your patient to develop ectopic pregnancy.

01:29 Fibrosis is not good for the intestinal area.

01:35 Remember, the fibroblasts that are coming in into the the interstitium extracellular matrix, pretty nonspecific, lay down the collagen then you might have adjacent structures that are involved.

01:46 And if you start having fibrotic deposition or collagen deposition affecting the intestines, this is what we call adhesions.

01:55 In fact, what do you think the most common cause of mechanical obstruction is of the intestine in the U.S. post surgery? Adhesions.

02:04 What are adhesions? Fibrosis.

02:07 Why? Damage.

02:10 Injury being introduced.

02:12 In this case, due to PID.

02:14 Bacteremia especially with enteric bacteria and, unfortunately, infertility.

02:20 Serious consequences and complications of PID.