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Bilateral recurrent pyosalpinx in a sexually inactive 12-year-old girl secondary to rare variant of Mullerian duct anomaly
  1. Tareq Maraqa,
  2. Mohamed Mohamed,
  3. Daniel Coffey,
  4. Gul R Sachwani-Daswani,
  5. Crystal Alvarez,
  6. Leo Mercer
  1. Department of Trauma, Hurley Medical Center, Flint, Michigan, USA
  1. Correspondence to Tareq Maraqa, tmaraqa1{at}


Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.1 2 Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.3 We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix. A preoperative diagnosis of acute ruptured appendicitis was given and she was taken to the operating room. Peroperative findings included bilaterally distended, pus-filled pyosalpinges. A definitive diagnosis of bilateral pyosalpinx was then made. Two-week antibiotic therapy was successful but the patient returned with recurrent pyosalpinx and a pelvic abscess 9 weeks later.

  • primary care
  • obstetrics and gynaecology
  • general surgery
  • paediatric surgery
  • general practice / family medicine

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  • Contributors TM, DC, MM and GRS-D provided critical input on the conception, design and revision of the manuscript. MM and GRS-D are contributed in writing the manuscript. LM and CA were the operating surgeons and also provided critical revisions for the submission of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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