Pelvic inflammatory disease. Endovaginal sonography with laparoscopic correlation

Area of Science:

• Gynecology
• Diagnostic Imaging
• Pelvic Inflammatory Disease

Background:

• Pelvic inflammatory disease (PID) is a serious infection that can lead to infertility.
• Accurate and timely diagnosis is crucial for effective treatment.

Purpose of the Study:

• To evaluate the sensitivity and accuracy of endo-vaginal ultrasound (EVUS) in diagnosing acute pelvic inflammatory disease (PID).
• To correlate EVUS findings with laparoscopic results for uterine and adnexal pathology.

Main Methods:

• Prospective study correlating EVUS findings with laparoscopic results.
• 16 patients with operatively confirmed acute PID were included.
• Sensitivity and accuracy of EVUS for tubal, ovarian, and uterine abnormalities were calculated.

Main Results:

• EVUS demonstrated high sensitivity for inflamed fallopian tubes (93%) and ovaries with peri-ovarian inflammation (90%).
• Overall accuracy for EVUS in predicting tubal and peri-ovarian disease was 93% and 91%, respectively.
• EVUS showed lower sensitivity for uterine abnormalities (25%) and missed small pelvic fluid collections (<20 cc) in 6/9 cases.

Conclusions:

• EVUS is a sensitive and accurate tool for identifying adnexal pathology in acute PID.
• EVUS has limitations in detecting uterine abnormalities and small fluid collections in PID.
• Laparoscopy remains valuable for confirming PID diagnoses when EVUS findings are equivocal or negative despite high clinical suspicion.