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The Use of Pelvic Ultrasonography in the Evaluation of Adolescents With Pelvic Inflammatory Disease

The Use of Pelvic Ultrasonography in the Evaluation of Adolescents With Pelvic Inflammatory Disease Abstract • To evaluate the use of pelvic ultrasonography in the diagnosis and management of female adolescents with pelvic inflammatory disease (PID), sonograms of 60 patients with PID were compared with those of 40 age-matched controls. Sonograms were evaluated for adnexal volume, adnexal adherence, uterine size, and the presence of cul-de-sac fluid. Eleven (19.3%) of the 57 patients with PID, in whom adequate sonograms were obtained, had tubo-ovarian abscesses; in seven of these patients, the abscesses were diagnosed ultrasonographically before suspected clinically. Even in those patients without tubo-ovarian abscesses, the mean (±SD) adnexal volume in the PID group was significantly larger than that of the control group (11.0±6.8 cm3 vs 5.2± 2.7 cm,3 respectively). Adnexal adherence, uterine size, and the presence of cul-de-sac fluid were not useful in differentiating patients with PID from normal controls. Pelvic ultrasonography can be a useful adjunct in the diagnosis and management of PID in adolescents and may, in some instances, provide diagnoses in the abscence of clinical findings. (AJDC 1987;141:1235-1238) References 1. Washington AE, Sweet RL, Shafer MB: Pelvic inflammatory disease and its sequelae in adolescents . J Adolesc Health Care 1985;6: 298-310.Crossref 2. Uhrich PC, Sanders RC: Ultrasonic characteristics of pelvic inflammatory masses . J Clin Ultrasound 1976;4:199-204.Crossref 3. Kirkpatrick RH, Nikrui N, Wittenberg J, et al: Gray-scale ultrasound in adnexal thickening: Correlation with laparoscopy . J Clin Ultrasound 1979;7:115-118.Crossref 4. Spaulding LB, Gelman SR, Wood SD, et al: The role of ultrasonography in the management of endometritis/salpingitis/peritonitis . Obstet Gynecol 1979;53:442-446. 5. Spirtos NJ, Bernstine RL, Crawford WL, et al: Sonography in acute pelvic inflammatory disease . J Reprod Med 1982;27:312-320. 6. Shafer MB, Irwin CE, Sweet RL: Acute salpingitis in the adolescent female . J Pediatr 1982;100:339-350.Crossref 7. Hager WD, Eschenbach DA, Spence MR, et al: Criteria for diagnosis and grading of salpingitis . Obstet Gynecol 1983;61:113-114. 8. Sexually transmitted diseases treatment guidelines 1982 . MMWR 1982;31( (suppl) ):375. 9. Sample WF, Lippe BM, Gyepes MT: Gray-scale ultrasonography of the normal female pelvis . Radiology 1977;125:477-483.Crossref 10. Forslin L, Falk V, Danielsson D: Changes in the incidence of acute gonococcal and nongonococcal salpingitis: A five-year study from an urban area of central Sweden . Br J Vener Dis 1978;54:247-250. 11. Westrom L: Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries . Am J Obstet Gynecol 1980;138:880-892. 12. Bell TA, Holmes KK: Age-specific risks of syphilis, gonorrhea and hospitalized pelvic inflammatory disease in sexually experienced US women . Sex Transm Dis 1984;11:291-295.Crossref 13. Jacobson L, Westrom L: Objectivized dia[ill] nosis of acute pelvic inflammatory disease: Dia[ill] nostic and prognostic value of routi[ill] laparoscopy . Am J Obset Gynecol 1969;10[ill] 1088-1098. 14. Hall DA: Sonographic appearance of t[ill] normal ovary, of polycystic ovary disease, and functional ovarian cysts . Semin Ultrasou[ill] 1983;4:149-165. 15. Taylor KJW, Wasson JF, DeGraaf C, et [ill] Accuracy of gray-scale ultrasound diagnosis abdominal and pelvic abscesses in 220 patient Lancet 1978;1:83-84.Crossref 16. Landers DV, Sweet RL: Tubo-ovarian a[ill] scess: Contemporary approach to managemen[ill] Rev Infect Dis 1983;5:876-884.Crossref 17. Berland LL, Lawson TL, Foley WD, et [ill] Ultrasound evaluation of pelvic infection Radiol Clin North Am 1982;20:367-382. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

The Use of Pelvic Ultrasonography in the Evaluation of Adolescents With Pelvic Inflammatory Disease

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460110105035
Publisher site
See Article on Publisher Site

Abstract

Abstract • To evaluate the use of pelvic ultrasonography in the diagnosis and management of female adolescents with pelvic inflammatory disease (PID), sonograms of 60 patients with PID were compared with those of 40 age-matched controls. Sonograms were evaluated for adnexal volume, adnexal adherence, uterine size, and the presence of cul-de-sac fluid. Eleven (19.3%) of the 57 patients with PID, in whom adequate sonograms were obtained, had tubo-ovarian abscesses; in seven of these patients, the abscesses were diagnosed ultrasonographically before suspected clinically. Even in those patients without tubo-ovarian abscesses, the mean (±SD) adnexal volume in the PID group was significantly larger than that of the control group (11.0±6.8 cm3 vs 5.2± 2.7 cm,3 respectively). Adnexal adherence, uterine size, and the presence of cul-de-sac fluid were not useful in differentiating patients with PID from normal controls. Pelvic ultrasonography can be a useful adjunct in the diagnosis and management of PID in adolescents and may, in some instances, provide diagnoses in the abscence of clinical findings. (AJDC 1987;141:1235-1238) References 1. Washington AE, Sweet RL, Shafer MB: Pelvic inflammatory disease and its sequelae in adolescents . J Adolesc Health Care 1985;6: 298-310.Crossref 2. Uhrich PC, Sanders RC: Ultrasonic characteristics of pelvic inflammatory masses . J Clin Ultrasound 1976;4:199-204.Crossref 3. Kirkpatrick RH, Nikrui N, Wittenberg J, et al: Gray-scale ultrasound in adnexal thickening: Correlation with laparoscopy . J Clin Ultrasound 1979;7:115-118.Crossref 4. Spaulding LB, Gelman SR, Wood SD, et al: The role of ultrasonography in the management of endometritis/salpingitis/peritonitis . Obstet Gynecol 1979;53:442-446. 5. Spirtos NJ, Bernstine RL, Crawford WL, et al: Sonography in acute pelvic inflammatory disease . J Reprod Med 1982;27:312-320. 6. Shafer MB, Irwin CE, Sweet RL: Acute salpingitis in the adolescent female . J Pediatr 1982;100:339-350.Crossref 7. Hager WD, Eschenbach DA, Spence MR, et al: Criteria for diagnosis and grading of salpingitis . Obstet Gynecol 1983;61:113-114. 8. Sexually transmitted diseases treatment guidelines 1982 . MMWR 1982;31( (suppl) ):375. 9. Sample WF, Lippe BM, Gyepes MT: Gray-scale ultrasonography of the normal female pelvis . Radiology 1977;125:477-483.Crossref 10. Forslin L, Falk V, Danielsson D: Changes in the incidence of acute gonococcal and nongonococcal salpingitis: A five-year study from an urban area of central Sweden . Br J Vener Dis 1978;54:247-250. 11. Westrom L: Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries . Am J Obstet Gynecol 1980;138:880-892. 12. Bell TA, Holmes KK: Age-specific risks of syphilis, gonorrhea and hospitalized pelvic inflammatory disease in sexually experienced US women . Sex Transm Dis 1984;11:291-295.Crossref 13. Jacobson L, Westrom L: Objectivized dia[ill] nosis of acute pelvic inflammatory disease: Dia[ill] nostic and prognostic value of routi[ill] laparoscopy . Am J Obset Gynecol 1969;10[ill] 1088-1098. 14. Hall DA: Sonographic appearance of t[ill] normal ovary, of polycystic ovary disease, and functional ovarian cysts . Semin Ultrasou[ill] 1983;4:149-165. 15. Taylor KJW, Wasson JF, DeGraaf C, et [ill] Accuracy of gray-scale ultrasound diagnosis abdominal and pelvic abscesses in 220 patient Lancet 1978;1:83-84.Crossref 16. Landers DV, Sweet RL: Tubo-ovarian a[ill] scess: Contemporary approach to managemen[ill] Rev Infect Dis 1983;5:876-884.Crossref 17. Berland LL, Lawson TL, Foley WD, et [ill] Ultrasound evaluation of pelvic infection Radiol Clin North Am 1982;20:367-382.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1987

References