Article on PID vs appendicitis

Summary of peer review

Aim of the study:

PID and appendicitis present in a very similar fashion which sometimes makes the diagnosis process challenging in the ER. This study aims to develop a scoring system to screen for PID and Acute Appendicitis in childbearing women who present to the ER complaining of abdominal pain.

Exclusion Criteria: pregnancy, appendectomy, known abdominal disease, prior menarche or menopause

Inclusion Criteria: childbearing women with abdominal pain

Sample size: N=279 childbearing women with age between 13-51

Method: the researchers came with 11 scoring variables to score the likelihood of PID vs. Appendicitis. The 11-scoring variable includes: pain onset, fever, abortion, vaginal secretions, taking a painkiller for dysmenorrhea, location of tenderness, sexual contact, migration of pain, Elevation of the WBC count, Gastro-intestinal symptoms. Each scoring variable is a score with 1 or 2 points.

Important Finding:

• If the scoring result is greater than 8 then there is high suspicion for PID
• The suspicion for appendicitis will rise if the score is greater than 10
• However, appendicitis should be higher on the differential diagnosis and should be ruled out/in by using abdominal
• ultrasonography or CT and then a surgeon should be consulted according to the results

The drawback of the studies

• This study was a single-center study; therefore, more diverse study is necessary to validate the research finding.
• There are confounding factors that were not considered including socioeconomic status, a medication history of oral contraceptives, condom use, smoking and the number of sexual partners. These confounding factors could be leading to the result.