Pelvic inflammatory disease. Endovaginal sonography with laparoscopic correlation

We correlated endo-vaginal ultrasound (EVUS) results with laparoscopic findings in 16 patients with operatively confirmed acute pelvic inflammatory disease to evaluate the sensitivity and accuracy of EVUS for identification of uterine and adnexal pathology. Laparoscopy confirmed prospective sonographic abnormalities in 25 of 27 inflamed fallopian tubes (sensitivity, 93%) and in 19 of 21 ovaries with peri-ovarian inflammation (sensitivity, 90%). Overall accuracy for EVUS prediction of peri-ovarian or tubal disease was 91% and 93%, respectively. However, EVUS was less sensitive to uterine abnormalities and detected inflammatory changes in only three of 12 confirmed cases (25%). EVUS also failed to demonstrate small quantities of purulent fluid (less than 20 cc) in the pelvic cul-de-sac in six of nine cases.