An Unusual Presentation of Pelvic Inflammatory Disease: Case Report and Discussion

Pelvic Inflammatory Disease (PID) generally results from an infectious process that involves the entire upper reproductive tract. It is generally felt that the inciting event is contraction of a sexually transmitted cervicitis, with ascension from the cervix leading to peritonitis. Classical teaching states that sterilization via tubal ligation is protective. Laparoscopy has been employed to establish or confirm a diagnosis when there is uncertainty or failure to respond to standard treatment. We present a case of PID occurring in a patient who had undergone a tubal ligation 20 years prior to presentation. Her low risk behavior and atypical complaints and physical exam findings necessitated laparoscopy to establish the diagnosis.