Appendicitis versus pelvic inflammatory disease. A diagnostic dilemma.

In order to determine whether any clinical or laboratory findings were helpful in differentiating acute appendicitis (AP) from acute pelvic inflammatory disease (PID), this retrospective study was undertaken. Records of all female patients 12 to 50 years of age, undergoing laparotomy with a preoperative diagnosis of AP over the past 15 years, were reviewed and pertinent data recorded. In comparing AP (n = 106) with PID (n = 39), longer duration of symptoms, relationship of onset of pain to the menstrual cycle, and frequent requests for gynecological consultation distinguished the PID from the AP cases. Although complete reliance cannot be placed on any clinical or laboratory finding in differentiating AP from PID, the final satisfactory outcome justifies laparotomy when the diagnosis cannot be established by other means.