Pelvic inflammatory disease other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laparoscopic identification is helpful in diagnosing tubal disease, 65-90% positive predictive value in patients with presumed PID (current obgyn 9th ed 2003). Regular Sexually transmitted disease (STD) testing is important for prevention. Treatment is usually started empirically because of the terrible complications. Definitive criteria include: histopathologic evidence of endometritis, thickened filled fallopian tubes, or laparoscopic findings. Gram-stain/smear becomes important in identification of rare and possibly more serious organisms

A sensitive serum pregnancy test should be obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix).

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