A 24-vear-old lady with 24 hrs comes with complains of pain in the right iliac fossa, vomiting, central dyspareunia, rebound tenderness and with a temperature of 37degC. Pregnancy test negative. The probable diagnosis is
(B) Acute PID # Pelvic inflammatory disease (PID) is an inflammatory disorder of the uterus, fallopian tubes, and adjacent pelvic structures. Risk factors for PID include young age at first intercourse, multiple sexual partners, intrauterine device (IUD) insertion, and tobacco smoking. A delay in diagnosis or treatment can result in long-term sequelae such as tubal infertility.> Patients can present with a variety of symptoms, ranging from lower abdominal pain to dysuria. A direct correlation exists between the incidence of STDs and pelvic inflammatory disease (PID) in any given population.> Pain is present in more than 90% of documented cases and is by far the most common presenting symptom. Usually, pain is described as dull, aching, and constant; it begins a few days after the onset of the last menstrual period and tends to be accentuated by motion, exercise, or coitus. Pain from PID usually lasts less than 7 days; if pain lasts longer than 3 weeks, the likelihood that PID is the correct diagnosis declines substantially.> Abnormal vaginal discharge is present in approximately 75% of cases.> Unanticipated vaginal bleeding coexists in about 40% of cases.> Temperature higher than 38degC (30%), nausea, and vomiting manifest late in the clinical course of the disease.
Acute appendicitis
Acute PID
Ectopic Pregnancy
Endometriosis
Miscellaneous (Gynae)