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Copyright (c) 2020 Ivan David Lozada Martinez, Christian Ospina Pérez, Rosa Ospina Pérez, Maria Paz Bolaño Romero
This work is licensed under a Creative Commons Attribution 4.0 International License.
Pelvic inflammatory disease as differential diagnosis of surgical abdominal pain
Corresponding Author(s) : Ivan David Lozada Martinez
Ciencia e Innovación en Salud,
2020
Abstract
Background: Pelvic Inflammatory Disease is defined as an infection of the upper female reproductive tract, generally secondary to an ascending infection from the endocervix, and which can generate any combination of endometritis, salpingitis, oophoritis or pelviperitonitis. Taking into account that the syndromic picture is generally nonspecific, it can easily simulate an acute surgical abdomen secondary to appendicitis, ectopic pregnancy, diverticulitis, urolithiasis, intestinal obstruction, among other entities. Conclusions: It is necessary to take into account a wide group of differential diagnoses, from gynaecologists to gastrointestinal and urological. Antibiotic treatment is often effective, although certain considerations need to be taken into account in risk groups such as pregnant and immunosuppressed women. Constantly re-evaluating the clinical condition is useful to determine whether or not there is worsening of the clinical picture and to contemplate surgical interventions for the solution of the problem. The main objectives in the area of promotion and prevention are aimed at sex education, especially among young people and adolescents, as well as at-risk groups.
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- Baquedano L, Lamarca M, Puig F, Ruiz M. Enfermedad inflamatoria pélvica: un reto en el diagnóstico y tratamiento precoz. Rev Chil Obstet. 2014; 79(2):115-120. https://scielo.conicyt.cl/pdf/rchog/v79n2/art09.pdf
- Haggerty CL, Ness RB. Epidemiology, pathogenesis and treatment of pelvic inflammatory disease. Expert Rev Anti Infect Ther. 2006; 4(2):235-47. DOI: 10.1586/14787210.4.2.235
- Grupo Desarrollador de la Guía de manejo sindrómico ITS y otras ITG. Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital – 2013. Rev Colomb Obstet Ginecol. 2012; 63:126-177. http://www.scielo.org.co/pdf/rcog/v64n2/v64n2a07.pdf
- Washington AE, Arno PS, Brooks MA. The Economic Cost of Pelvic Inflammatory Disease. JAMA. 1986; 255(13):1735–1738. https://pubmed.ncbi.nlm.nih.gov/3951103/
- Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. N Engl J Med 2015; 372(21):2039-2048. DOI: 10.1056/NEJMra1411426
- Mathur M, Scoutt L. Nongynecologic Causes of Pelvic Pain: Ultrasound First. Obstet Gynecol Clin N Am. 2019; 46:733–753. DOI: 10.1016/j.ogc.2019.07.007
- Ross J, Judlin P, Jensen J. 2012 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2014; 25(1):1-7. DOI: 10.1177/0956462413498714
- Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: should we treat and how? Clin Infect Dis. 2011; 53(S-3):S129-S142. DOI: 10.1093/cid/cir702
- Wiesenfeld H, Cates WJ. Sexually transmitted diseases and infertility. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York: McGraw-Hill, 2008. DOI: 10.1016/j.ogrm.2019.06.005
- Paavonen J, Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York: McGraw-Hill, 2008.
- Baker D, Simpson L. Medical and surgical management of chronic pelvic pain. Obstetrics, Gynaecology & Reproductive Medicine. 2019; 29(10):273-280. https://doi.org/10.1016/j.ogrm.2019.06.005
- Jennings L, Krywko D. Pelvic Inflammatory Disease [Internet]. USA; 2019. [Consultado 2020 May 5]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK499959/
- Morcos R, Frost N, Hnat M, Petrunak A, Caldito G. Laparoscopic versus clinical diagnosis of acute pelvic inflammatory disease. J Reprod Med 1993; 38: 53–56. https://pubmed.ncbi.nlm.nih.gov/8441133/
- Dewey K, Wittrock C. Acute Pelvic Pain. Emerg Med Clin N Am. 2019; 37:207–218.
- DOI: 10.1016/j.emc.2019.01.012
- Hodler J, Kubik-Huch R, von Schulthess G. Diseases of the Abdomen and Pelvis 2018–2021: Diagnostic Imaging. First edition. Switzerland: Springer International Publishing; 2018.
- Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol. 2010; 150(1):8–12. DOI: 10.1016/j.ejogrb.2010.02.006
- Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990; 132(5):910–25. https://pubmed.ncbi.nlm.nih.gov/2239906/
- Ross J, Guaschino S, Cusini M, Jensen J. 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018; 29(2):108-114. DOI: 10.1177/0956462417744099
- Becker JH, de Graaff J, Vos MC, et al. Torsion of the ovary: a known but frequently missed diagnosis. Eur J Emerg Med. 2009; 16(3):124–6. https://pubmed.ncbi.nlm.nih.gov/19262396/
- Workowski KA, Berman S. Sexually transmited diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR12):1-110. https://pubmed.ncbi.nlm.nih.gov/21160459/
- Peipert JF, Boardman L, Hogan JW, Sung J, Mayer K. Laboratory evaluation of acute upper genital tract infection. Obstet Gynecol. 1996; 87(5 Pt 1):730–6. https://pubmed.ncbi.nlm.nih.gov/8677076/
- Peipert JF, Ness RB, Blume J, Soper DE, Holley R, Randall H, et al. Clinical predictors of endometritis in women with symptoms and signs of pelvic inflammatory disease. Am J Obstet Gynecol. 2001; 184(5):856–63. https://pubmed.ncbi.nlm.nih.gov/11303192/
- Cacciatore B, Leminen A, Ingman-Friberg S, Ylöstalo P, Paavonen J. Transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease. Obstet Gynecol. 1992; 80(6):912–6. https://pubmed.ncbi.nlm.nih.gov/1448258/
- Mitchell C, Prabhu M. Pelvic Inflammatory Disease Current Concepts in Pathogenesis, Diagnosis and Treatment. Infect Dis Clin N Am. 2013; 27:793–809. DOI: 10.1016/j.idc.2013.08.004
- Kamenga MC, De Cock KM, St Louis ME, Touré CK, Zakaria S, N'gbichi JM, et al. The impact of human immunodeficiency virus infection on pelvic inflammatory disease: a case-control study in Abidjan, Ivory Coast. Am J Obstet Gynecol. 1995; 172:919–925. https://pubmed.ncbi.nlm.nih.gov/7892886/
- Irwin KL, Moorman AC, O'Sullivan MJ, Sperling R, Koestler ME, Soto I, et al. Influence of human immunodeficiency virus infection on pelvic inflammatory disease. Obstet Gynecol. 2000; 95:525–534. https://pubmed.ncbi.nlm.nih.gov/10725484/
- Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64(RR-03):1-137. https://pubmed.ncbi.nlm.nih.gov/8441133/
- Organización Panamericana de la Salud. Tratamiento de las enfermedades infecciosas 2020-2022. Octava edición. Washington, D.C.: OPS; 2019.
- Soper D. Surgical Considerations in the Diagnosis and Treatment of Pelvic Inflammatory Disease. Surg Clin N Am. 1991; 71(5):947-962. https://pubmed.ncbi.nlm.nih.gov/1833838/
- Bland K, Büchler M, Csendes A, Sarr M, Garden J, Wong J. General Surgery: Principles and International Practice. Second edition. Switzerland: Springer International Publishing; 2009.
- Risser WL, Risser JM, Risser AL. Current perspectives in the USA on the diagnosis and treatment of pelvic inflammatory disease in adolescents. Adolesc Health Med Ther. 2017; 8:87-94. DOI: 10.2147/AHMT.S115535
- Das BB, Ronda J, Trent M. Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infect Drug Resist. 2016; 9:191-7. DOI: 10.2147/IDR.S91260
- Jennings L, Krywko D. Pelvic Inflammatory Disease (PID) [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 [Consultado 11 Jun 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK499959/
References
Baquedano L, Lamarca M, Puig F, Ruiz M. Enfermedad inflamatoria pélvica: un reto en el diagnóstico y tratamiento precoz. Rev Chil Obstet. 2014; 79(2):115-120. https://scielo.conicyt.cl/pdf/rchog/v79n2/art09.pdf
Haggerty CL, Ness RB. Epidemiology, pathogenesis and treatment of pelvic inflammatory disease. Expert Rev Anti Infect Ther. 2006; 4(2):235-47. DOI: 10.1586/14787210.4.2.235
Grupo Desarrollador de la Guía de manejo sindrómico ITS y otras ITG. Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital – 2013. Rev Colomb Obstet Ginecol. 2012; 63:126-177. http://www.scielo.org.co/pdf/rcog/v64n2/v64n2a07.pdf
Washington AE, Arno PS, Brooks MA. The Economic Cost of Pelvic Inflammatory Disease. JAMA. 1986; 255(13):1735–1738. https://pubmed.ncbi.nlm.nih.gov/3951103/
Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. N Engl J Med 2015; 372(21):2039-2048. DOI: 10.1056/NEJMra1411426
Mathur M, Scoutt L. Nongynecologic Causes of Pelvic Pain: Ultrasound First. Obstet Gynecol Clin N Am. 2019; 46:733–753. DOI: 10.1016/j.ogc.2019.07.007
Ross J, Judlin P, Jensen J. 2012 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2014; 25(1):1-7. DOI: 10.1177/0956462413498714
Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: should we treat and how? Clin Infect Dis. 2011; 53(S-3):S129-S142. DOI: 10.1093/cid/cir702
Wiesenfeld H, Cates WJ. Sexually transmitted diseases and infertility. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York: McGraw-Hill, 2008. DOI: 10.1016/j.ogrm.2019.06.005
Paavonen J, Westrom L, Eschenbach D. Pelvic inflammatory disease. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually transmitted diseases. 4th ed. New York: McGraw-Hill, 2008.
Baker D, Simpson L. Medical and surgical management of chronic pelvic pain. Obstetrics, Gynaecology & Reproductive Medicine. 2019; 29(10):273-280. https://doi.org/10.1016/j.ogrm.2019.06.005
Jennings L, Krywko D. Pelvic Inflammatory Disease [Internet]. USA; 2019. [Consultado 2020 May 5]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK499959/
Morcos R, Frost N, Hnat M, Petrunak A, Caldito G. Laparoscopic versus clinical diagnosis of acute pelvic inflammatory disease. J Reprod Med 1993; 38: 53–56. https://pubmed.ncbi.nlm.nih.gov/8441133/
Dewey K, Wittrock C. Acute Pelvic Pain. Emerg Med Clin N Am. 2019; 37:207–218.
DOI: 10.1016/j.emc.2019.01.012
Hodler J, Kubik-Huch R, von Schulthess G. Diseases of the Abdomen and Pelvis 2018–2021: Diagnostic Imaging. First edition. Switzerland: Springer International Publishing; 2018.
Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol. 2010; 150(1):8–12. DOI: 10.1016/j.ejogrb.2010.02.006
Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990; 132(5):910–25. https://pubmed.ncbi.nlm.nih.gov/2239906/
Ross J, Guaschino S, Cusini M, Jensen J. 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018; 29(2):108-114. DOI: 10.1177/0956462417744099
Becker JH, de Graaff J, Vos MC, et al. Torsion of the ovary: a known but frequently missed diagnosis. Eur J Emerg Med. 2009; 16(3):124–6. https://pubmed.ncbi.nlm.nih.gov/19262396/
Workowski KA, Berman S. Sexually transmited diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR12):1-110. https://pubmed.ncbi.nlm.nih.gov/21160459/
Peipert JF, Boardman L, Hogan JW, Sung J, Mayer K. Laboratory evaluation of acute upper genital tract infection. Obstet Gynecol. 1996; 87(5 Pt 1):730–6. https://pubmed.ncbi.nlm.nih.gov/8677076/
Peipert JF, Ness RB, Blume J, Soper DE, Holley R, Randall H, et al. Clinical predictors of endometritis in women with symptoms and signs of pelvic inflammatory disease. Am J Obstet Gynecol. 2001; 184(5):856–63. https://pubmed.ncbi.nlm.nih.gov/11303192/
Cacciatore B, Leminen A, Ingman-Friberg S, Ylöstalo P, Paavonen J. Transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease. Obstet Gynecol. 1992; 80(6):912–6. https://pubmed.ncbi.nlm.nih.gov/1448258/
Mitchell C, Prabhu M. Pelvic Inflammatory Disease Current Concepts in Pathogenesis, Diagnosis and Treatment. Infect Dis Clin N Am. 2013; 27:793–809. DOI: 10.1016/j.idc.2013.08.004
Kamenga MC, De Cock KM, St Louis ME, Touré CK, Zakaria S, N'gbichi JM, et al. The impact of human immunodeficiency virus infection on pelvic inflammatory disease: a case-control study in Abidjan, Ivory Coast. Am J Obstet Gynecol. 1995; 172:919–925. https://pubmed.ncbi.nlm.nih.gov/7892886/
Irwin KL, Moorman AC, O'Sullivan MJ, Sperling R, Koestler ME, Soto I, et al. Influence of human immunodeficiency virus infection on pelvic inflammatory disease. Obstet Gynecol. 2000; 95:525–534. https://pubmed.ncbi.nlm.nih.gov/10725484/
Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64(RR-03):1-137. https://pubmed.ncbi.nlm.nih.gov/8441133/
Organización Panamericana de la Salud. Tratamiento de las enfermedades infecciosas 2020-2022. Octava edición. Washington, D.C.: OPS; 2019.
Soper D. Surgical Considerations in the Diagnosis and Treatment of Pelvic Inflammatory Disease. Surg Clin N Am. 1991; 71(5):947-962. https://pubmed.ncbi.nlm.nih.gov/1833838/
Bland K, Büchler M, Csendes A, Sarr M, Garden J, Wong J. General Surgery: Principles and International Practice. Second edition. Switzerland: Springer International Publishing; 2009.
Risser WL, Risser JM, Risser AL. Current perspectives in the USA on the diagnosis and treatment of pelvic inflammatory disease in adolescents. Adolesc Health Med Ther. 2017; 8:87-94. DOI: 10.2147/AHMT.S115535
Das BB, Ronda J, Trent M. Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infect Drug Resist. 2016; 9:191-7. DOI: 10.2147/IDR.S91260
Jennings L, Krywko D. Pelvic Inflammatory Disease (PID) [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 [Consultado 11 Jun 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK499959/