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Acute pelvic inflammatory disease after surgical sterilization
M M Green1, S J Vicario, J S Sanfilippo
1Department of Emergency Medicine, University of Louisville School of Medicine, Kentucky 40292.
Study Objective:
Physicians are very cognizant of the possibility of pregnancy after surgical sterilization, but the potential for acute pelvic inflammatory disease (PID) is thought to be rare. This study was undertaken to determine if upper tract PID occurred more frequently than previously reported in patients remote from surgical sterilization.
Design:
Retrospective review of hospitalized patients with the primary discharge diagnosis of PID.
Setting:
Urban, university hospital.
Participants:
Three hundred sixty-four hospitalized patients with the primary discharge diagnosis of PID over a six-year study period.
Measurements And Main Results:
Patients' age; gynecologic histories and diagnoses; and laboratory, clinical, and surgical findings were noted. Twenty-three cases of acute PID were identified in 21 patients previously sterilized (6%). Nine of the 23 cases had systemic toxicity warranting surgical evaluation; 18 of the 23 cases were admitted from the emergency department. Mean statistical characteristics of the study group were age, 27.3 +/- 0.8 (SE) years; time interval from sterilization, 49.8 +/- 7.4 months; WBC 15,000 +/- 1,200; and temperature, 38.0 +/- 0.2 C.
Conclusion:
We conclude that acute PID may occur more frequently than previously reported in patients with prior surgical sterilization. An increased awareness of this entity is warranted.