Transvaginal ultrasound of a febrile 27-year-old with acute pelvic pain shows a dilated, tortuous, sausage-shaped tubular structure with thick walls and low-level internal echoes and debris within the lumen. This appearance is MOST consistent with:
- A Hydrosalpinx
- B Pyosalpinx ✓
- C Simple paraovarian cyst
- D Dilated pelvic vein
Correct answer: B. Pyosalpinx
Explanation
Pyosalpinx is an acutely inflamed, pus-filled tube appearing as a thick-walled, distended tubular structure with echogenic contents representing pus and debris. Hydrosalpinx, the chronic sequela, shows a thin-walled tube with completely anechoic fluid, which distinguishes option A. Paraovarian cysts are round and separate from the tube, and pelvic veins show colour Doppler flow rather than wall thickening with luminal debris.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.