Differentiating acute appendicitis from pelvic inflammatory disease in women of childbearing age.
A retrospective study was performed to evaluate the usefulness of various historical, clinical, and laboratory findings in differentiating acute appendicitis from pelvic inflammatory disease (PID) in women of childbearing age. The records of all female patients presenting to the emergency department with abdominal pain who were found to have histologically proven appendicitis (n = 80) or PID confirmed on endocervical culture (n = 71) were reviewed. Clinically useful indicators favoring appendicitis included the presence of anorexia and the onset of pain later than day 14 of the menstrual cycle. Indicators favoring PID included a history of vaginal discharge, urinary symptoms, prior PID, tenderness outside the right lower quadrant, cervical motion tenderness, vaginal discharge on pelvic examination, and positive urinalysis. Despite these indicators, differentiating acute appendicitis from PID remains difficult.
Webster
D P
DP
Department of Emergency Medicine, Chicago College of Osteopathic Medicine, IL 60615.
Schneider
C N
CN
Cheche
S
S
Daar
A A
AA
Miller
G
G
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000855:Anorexia / Q000209:etiology; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008597:Menstrual Cycle; D010146:Pain / Q000209:etiology; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies