Acute salpingitis--laparoscopic and microbiological evaluation.

Abstract

The diagnosis as well as the severity of acute pelvic inflammatory disease (APID) can be difficult to assess clinically. A study was undertaken to compare the accuracy of clinical findings (Gainesville classification) with laparoscopic findings in 28 patients with APID in terms of: (i) establishing the correct diagnosis; (ii) determining the severity of the disease; and (iii) obtaining specimens to establish the causative organisms. The results were as follows: (i) (a) clinical diagnosis of APID was confirmed by laparoscopic evaluation in 78.6% of cases; (b) clinical staging of APID correlated with laparoscopic findings in 82.6% of cases; (ii) severity of the clinical staging of APID correlated with that of laparoscopic staging; and (iii) polymicrobial cause, as reported by other investigators, was confirmed. Laparoscopic evaluation was of importance in eliminating the inaccuracy of clinical diagnosis in 21.4% of cases and in establishing the causative organisms so that optimal treatment could be given and the long-term after-effects of APID reduced.