Differential diagnosis of acute pelvic inflammatory disease.

Laparoscopic investigations have shown that clinical symptoms and signs in cases of acute pelvic inflammatory disease (acute salpingitis) show considerable variation and seem to a great extent to be nonspecific. Diagnosis based on clinical criteria alone is, therefore, unacceptably unreliable. Different intrapelvic disorders and acute infections limited to the lower genital tract (LGTI) represent substantial differential diagnostic problems. The routine use of laparoscopy is currently the best method for solving these problems but its broader application is restricted by several factors. Determination of specific genital isoamylases obtained at vaginal puncture of the cul-de-sac seems to represent a promising and specific laboratory test for differentiating between acute PID and LGTI that simulates acute PID.