1. What is it?
1.1. Infection that spreads upwards from vulva/vagina into the female genital system
2. Morphology
2.1. Acute purulent inflammation
2.2. Abcesses
2.2.1. Tubo-ovarian
2.2.2. Pyosalpinx
2.3. Fibrosis
2.4. Fibrinous component
3. Complications
3.1. Local spread
3.1.1. acute suppurative salpingitis
3.1.1.1. tubal mucosa filled with n/ph, pc, ly -> epi sloughing of the plicae
3.1.1.1.1. lumen fills with exudate and possible leakage through fimbriae
3.1.2. salpingo-oophoritis
3.1.2.1. salpingitis spreads to ovary
3.1.3. Pyovarium
3.1.3.1. ???
3.1.4. Pyosalpinx
3.2. Acute
3.2.1. periontitis & bacteremia by staph/strep
3.2.1.1. infectious endocarditis
3.2.1.2. purulent meningitis
3.2.1.3. purulent arthritis
3.3. Chronic (fibrous adhesions)
3.3.1. intestinal obstruction
3.3.2. infertility
3.3.3. tubal obstruction
3.3.3.1. hydrosalpinx
3.3.3.1.1. fusion of the fimbriae or obstruction
3.3.4. ectopic pregnancy
4. Etiology
4.1. 1st most common: N. gonorrhoea
4.2. 2nd most common: Chlamydia
4.3. Puerperal infections
4.3.1. Staphylococci
4.3.2. Streptococci
4.3.3. Clostridium perfringens
4.3.4. Coliforms
5. Route of infection
5.1. N. gonorrhoea
5.1.1. endocervical mucosa or glands, reaches tubes and tubo-ovarian region
5.2. Non-gonococcal bacterial infections
5.2.1. abortion, dilation and curettage of the uterus
5.2.2. ascending spread via lymphatic and venous system
5.2.3. inflammation in deeper tissue than gonococcal infection
5.2.3.1. serosa, ligaments, pelvic structures, and peritoneum