Laparoscopic management of suspected acute pelvic inflammatory disease

Study Objective. To evaluate the efficacy of acute-phase operative laparoscopy in women with suspected pelvic inflammatory disease (PID). Design. Open series (Canadian Task Force classification II-3). Setting. University hospital. Patients. Thirty-three patients with clinically suspected PID. Intervention. Acute-phase operative laparoscopy. Measurements and Main Results. Laparoscopy confirmed the diagnosis of PID in 20 (61%) patients; 11 (33%) women had other disease and 2 (6%) had no evidence of disease. Laparoscopic procedures in women with PID were pelvic irrigation (all patients), lysis of adhesions (most cases), drainage and irrigation of unilateral or bilateral pyosalpinx (7), drainage and irrigation of tubo-ovarian abscess (3), and extirpation of disease (2). Laparoscopic intervention was also performed in 11 (85%) of 13 women without PID. No major complications occurred. Conclusion. Acute-phase operative laparoscopy provided a final diagnosis in all but three patients (91%).