Ultrasound examination of adolescent females with lower abdominal pain

We evaluated pelvic ultrasound examination in adolescent females as an aid in the diagnosis of acute and chronic lower abdominal pain resulting from suspected gynecologic disease. Of 41 subjects, 35 (85.4%) had a final diagnosis of a gynecologic disorder. Pelvic ultrasound examination was positive in 19 of 35 (54.3%). Ten positive tests had relatively specific findings that supported (seven) or helped change (three) the initial clinical diagnosis. Nine positive tests had nonspecific findings that were consistent with (six) or helped change (three) the initial diagnosis. Twenty-one negative tests helped change the initial diagnosis (13); ruled out complications of acute salpingitis (five); or discriminated between alternative diagnoses (three). One test was falsely positive. Ultrasonography was most clearly cost-effective when surgery was being considered. We conclude that pelvic ultrasound examination may be a useful diagnostic adjunct in this type of adolescent patient.