Risk Factors. The most common risk factor is female sexual activity in
adolescence, with multiple partners. PID is increased in the month after insertion
of an IUD, but this is probably exacerbation of preexisting subclinical infection.
of the cervical mucus barrier, the pathogenic organisms ascend through the
uterus causing an endometritis; then the bacteria enter the oviduct where acute
salpingo-oophoritis develops.
Chronic PID: If the salpingo-oophoritis is not appropriately treated, the
body’s immune defenses will often overcome the infection but at the expense
of persistent adhesions and scarring.
Tubo-ovarian abscess (TOA): If the body’s immune defenses cannot
overcome the infection, the process worsens, producing an inflammatory
mass involving the oviducts, ovaries, uterus, bowel, and omentum.