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The Journal of the American Board of... 1994Acute pelvic inflammatory disease (PID) is a major gynecologic health problem in the United States, afflicting more than 1 million women each year and generating annual... (Review)
Review
BACKGROUND
Acute pelvic inflammatory disease (PID) is a major gynecologic health problem in the United States, afflicting more than 1 million women each year and generating annual direct and indirect costs estimated at $4.2 billion. Family physicians can play an important role in the prevention, as well as diagnosis and treatment, of PID.
METHODS
A MEDLINE search for articles published from 1985 to the present was made using the key words "pelvic inflammatory disease," "endometritis," "salpingitis," "tubo-ovarian abscess," "adnexitis," "pelvic abscess," "parametritis," and "oophoritis." The bibliographies of these articles and the author's personal files were also sources of information.
RESULTS AND CONCLUSIONS
A number of risk factors have been linked to PID, including young age, age at first intercourse, multiple sex partners, the presence of bacterial vaginosis, vaginal douching, the use of an intrauterine contraceptive device, and a history of a sexually transmitted disease. The diagnosis of PID represents a major clinical challenge that requires a careful history and physical examination coupled with selective and knowledgeable use of the diagnostic tests and procedures currently available. Broad-spectrum antibiotics, which represent the cornerstone of therapy, must adequately cover the polymicrobial spectrum of pathogens implicated in this infection, which includes Neisseria gonorrhoeae, Chlamydia trachomatis, and specific cervicovaginal anaerobic and aerobic bacteria. The numerous sequelae associated with PID, which include infertility, ectopic pregnancy, and chronic pelvic pain syndromes, underscore the need for effective measures for preventing pelvic inflammatory disease.
Topics: Acute Disease; Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Diagnosis, Differential; Female; Humans; Incidence; Pelvic Inflammatory Disease; Risk Factors; Sexually Transmitted Diseases
PubMed: 8184701
DOI: No ID Found -
Fertility and Sterility Nov 1997To review the diagnostic and therapeutic roles of laparoscopy in women of reproductive age with acute and chronic pelvic pain. (Review)
Review
OBJECTIVE
To review the diagnostic and therapeutic roles of laparoscopy in women of reproductive age with acute and chronic pelvic pain.
DATA IDENTIFICATION
Studies relating to the use of laparoscopy in women with acute and chronic pelvic pain were identified through the literature and MEDLINE searches.
CONCLUSION(S)
Laparoscopy has an important place in the management of conditions that cause acute pelvic pain in women of reproductive age, including ectopic pregnancy, pelvic inflammatory disease, tubo-ovarian abscess, and adnexal torsion. The procedure frequently facilitates the diagnosis and provides the necessary access for surgical treatment. Prompt diagnosis and effective management prevent complications and help preserve fertility. The role of laparoscopy in women with chronic pelvic pain is more controversial and limited, but abnormal laparoscopic findings are detected in approximately 60% of those who have undergone a multidisciplinary investigation and received a tentative clinical diagnosis. The access provided by laparoscopy permits the effective surgical treatment of many of the conditions encountered, including endometriosis, pelvic adhesions, ovarian lesions, and symptomatic uterine retroversion.
Topics: Adnexal Diseases; Female; Humans; Laparoscopy; MEDLINE; Pelvic Inflammatory Disease; Pelvic Pain; Pregnancy; Pregnancy, Ectopic; United States; Uterine Diseases
PubMed: 9389799
DOI: 10.1016/s0015-0282(97)00192-1 -
Genitourinary Medicine Feb 1993
Review
Topics: Actinomyces; Actinomycosis; Female; Genital Diseases, Female; Humans; Intrauterine Devices; Pelvic Inflammatory Disease
PubMed: 8444484
DOI: 10.1136/sti.69.1.54 -
Journal de Gynecologie, Obstetrique Et... Dec 2012Diagnosis of pelvic inflammatory disease is difficult. We focus on a systematic literature review to study diagnostic values of history-taking, clinical examination,... (Review)
Review
Diagnosis of pelvic inflammatory disease is difficult. We focus on a systematic literature review to study diagnostic values of history-taking, clinical examination, laboratory tests and imagery. After this literature review, we build a diagnostic model for pelvic inflammatory disease. This diagnostic model is built on two major criteria: presence of adnexal tenderness or cervical motion tenderness. Additional minor criteria, increasing the likelihood of the diagnosis of pelvic inflammatory disease were added based on their specificity and their positive likelihood ratio. These minor criteria are supported by history-taking, clinical examination, laboratory tests and also on relevant ultrasonographic criteria.
Topics: Adolescent; Adult; Cervix Uteri; Chlamydia Infections; Chlamydia trachomatis; Diagnostic Imaging; Female; France; Humans; Laparoscopy; Leukorrhea; MEDLINE; Metrorrhagia; Palpation; Pelvic Inflammatory Disease; Pelvic Pain; Young Adult
PubMed: 23140620
DOI: 10.1016/j.jgyn.2012.09.016 -
Sexually Transmitted Infections Aug 2004
Topics: Endometritis; Female; Humans; Pelvic Inflammatory Disease; Prognosis
PubMed: 15295119
DOI: 10.1136/sti.2004.009548 -
Reviews of Infectious Diseases 1986Pelvic inflammatory disease accounts for 5%-20% of hospital admissions for gynecologic problems and is associated with health care costs of more than 1 billion dollars... (Clinical Trial)
Clinical Trial Review
Pelvic inflammatory disease accounts for 5%-20% of hospital admissions for gynecologic problems and is associated with health care costs of more than 1 billion dollars annually. This article reviews the epidemiology, polymicrobial etiology, and diagnosis of this disease state. Special consideration is given to in vivo and in vitro studies of antimicrobial therapy, including both established regimens and expanded-spectrum beta-lactam antibiotics. The adjunctive modalities reviewed include treatment of sexual contacts, removal of intrauterine devices, use of alternative contraceptive methods associated with a reduced risk of disease, and surgery. Although understanding of pelvic inflammatory disease has increased markedly, investigation of its various aspects is both necessary and ongoing. In particular, well-designed, controlled, comparative clinical trials of new treatment regimens must be performed to verify a true advantage of these therapies.
Topics: Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Cephalosporins; Chlamydia Infections; Clinical Trials as Topic; Contraceptive Agents, Female; Female; Gonorrhea; Humans; Infertility, Female; Inpatients; Intrauterine Devices; Laparoscopy; Outpatients; Pain; Pelvic Inflammatory Disease; Penicillins; Pregnancy; Pregnancy, Ectopic; Recurrence; Salpingitis; Sexual Behavior
PubMed: 2937130
DOI: 10.1093/clinids/8.1.86 -
Archives of Gynecology and Obstetrics Apr 2014This review aims to sum up current knowledge on the sensitivity and specificity of ultrasound features suggestive of acute pelvic inflammatory disease (PID). (Review)
Review
PURPOSE
This review aims to sum up current knowledge on the sensitivity and specificity of ultrasound features suggestive of acute pelvic inflammatory disease (PID).
METHODS
A PubMed database search was undertaken, using the MeSH terms "(pelvic inflammatory disease or salpingitis or adnexitis) and ultrasonography". We included original articles evaluating the performance of vaginal ultrasound in detecting acute PID.
RESULTS
Seven articles were selected, including between 18 and 77 patients each. The golden standard used was laparoscopy/endometrial biopsy in six studies and mostly clinical evaluation in one. "Thick tubal walls" proved to be a specific and sensitive ultrasound sign of acute PID, provided that the walls of the tubes can be evaluated, i.e., when fluid is present in the tubal lumen (100 % sensitivity). The cogwheel sign is also a specific sign of PID (95-99 % specificity), but it seems to be less sensitive (0-86 % sensitivity). Bilateral adnexal masses appearing either as small solid masses or as cystic masses with thick walls and possibly manifesting the cogwheel sign also seems to be a reasonably reliable sign (82 % sensitivity, 83 %specificity). Doppler results overlap too much between women with and without acute PID for them to be useful in the diagnosis of acute PID, even though acutely inflamed tubes are richly vascularized at color Doppler.
CONCLUSIONS
Even though the results of our review suggest that transvaginal ultrasound has limited ability to diagnose acute PID, it is likely to be helpful when managing women with symptoms of acute PID, because in some cases the typical ultrasound signs of acute PID can be detected.
Topics: Adnexa Uteri; Blood Flow Velocity; Douglas' Pouch; Female; Humans; Pelvic Inflammatory Disease; Salpingitis; Sensitivity and Specificity; Ultrasonography, Doppler; Uterine Artery
PubMed: 24287707
DOI: 10.1007/s00404-013-3091-6 -
Pediatric Clinics of North America Aug 1999Pelvic inflammatory disease is the most significant consequence of sexually transmitted infections. Statistics suggest that adolescents have a significantly higher rate... (Review)
Review
Pelvic inflammatory disease is the most significant consequence of sexually transmitted infections. Statistics suggest that adolescents have a significantly higher rate of PID than does any other age group. Even asymptomatic and minimally symptomatic PID can lead to adhesions, infertility, and ectopic pregnancy, so clinicians should maintain a high index of suspicion when evaluating female adolescents with lower abdominal pain. Empiric treatment, including appropriate partner notification and treatment, should be initiated early.
Topics: Adolescent; Diagnosis, Differential; Female; Humans; Patient Education as Topic; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Complications, Infectious; Risk Factors
PubMed: 10494256
DOI: 10.1016/s0031-3955(05)70151-6 -
Orvosi Hetilap May 1983
Topics: Adolescent; Appendectomy; Appendicitis; Child; Female; Humans; Pelvic Inflammatory Disease; Postoperative Complications
PubMed: 6683396
DOI: No ID Found -
Zeitschrift Fur Arztliche Fortbildung Feb 1972
Comparative Study
Topics: Adolescent; Adult; Chemical Phenomena; Chemistry; Chloramphenicol; Chronic Disease; Chymotrypsin; Costs and Cost Analysis; Female; Hospitalization; Humans; Length of Stay; Pelvic Inflammatory Disease; Physical Therapy Modalities; Prednisone
PubMed: 5047086
DOI: No ID Found