The Usefulness of Computed Tomography for Clinical Diagnosis of Pelvic Inflammatory Disease in an Emergency Department

ABSTRACT

PURPOSE: Early detection and appropriate treatment of pelvic inflammatory disease (PID) are important to prevent adverse sequelae. The purpose of this study was to evaluate the usefulness of computed tomography (CT) for diagnosis of PID in an emergency department (ED). METHODS: We undertook a retrospective review of patients with acute low abdominal pain who were checked by abdominal CT in the ED at a tertiary hospital between June 2009 and December 2009. Inclusion criteria were PID on CT or non specific findings on CT and a consultation to the gynecology department. Exclusion criteria were age less than 15 years, age greater than 60 years, definite other causes for the acute low abdominal pain seen on CT, intact virginity, and transfer to another hospital. We compared clinical characteristics and laboratory findings between group A (clinically diagnosed PID patients) and group B (non-PID patients). We calculated sensitivity and specificity of CT findings to predict clinical diagnosis of PID. RESULTS: A total of 68 patients were enrolled in this study. Median age was 31 years (24-39). Group A consisted of 51 patients; group B of 17 patients. Cervical motion tenderness (p=0.001) and WBC count (p=0.013) were significantly different between the two groups. The accuracy of PID findings on CT for predicting the clinical diagnosis of PID was 85.29%. The sensitivity and specificity were 92.16% and 64.71%, respectively. Leukorrhea had a sensitivity of 76.47% and a specificity of 47.06%. Cervical motion tenderness had a sensitivity of 87.18% and a specificity of 75%. CONCLUSION: Abdominal CT performed in the ED is a useful method for the clinical diagnosis of PID.