• Valerie I Shavell, Mazen E Abdallah, Jeffrey A Triest, and Michael P Diamond.
• Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA. vshavell@med.wayne.edu
• Obstet Gynecol. 2009 Feb 1; 113 (2 Pt 2): 522-5.

BackgroundAcute pelvic pain in reproductive-aged women presents a diagnostic challenge. In the case that follows, we report the management of a patient initially misdiagnosed with pelvic inflammatory disease.CaseA 14-year-old nulligravida who presented with acute pelvic pain was diagnosed with pelvic inflammatory disease and possible tuboovarian abscess. Despite treatment with broad-spectrum parenteral antibiotics, the patient remained febrile with persistent pelvic pain. Com-puted tomography revealed a duplicated right collecting system with the upper pole of the kidney drained by a markedly dilated, tortuous ureter. An infected ureterocele was identified and incised during cystoscopy.ConclusionAn infected ureterocele was misdiagnosed as pelvic inflammatory disease. In patients with acute pelvic pain who do not respond to appropriate interventions, it is important to consider alternative diagnoses.

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