Which investigation provides the definitive (gold standard) diagnosis of acute salpingitis in a woman with suspected PID?

• A Diagnostic laparoscopy visualising inflamed fallopian tubes with exudate ✓
• B Endometrial biopsy demonstrating plasma cells
• C Transvaginal ultrasound showing thickened fluid-filled tubes
• D High vaginal swab cultured for Neisseria gonorrhoeae

Explanation

Laparoscopy with direct visualisation of hyperaemic, oedematous tubes and fimbrial exudate is the accepted gold standard for diagnosing salpingitis, but its invasiveness means empirical treatment based on clinical criteria remains standard practice. Ultrasound and endometrial biopsy are supportive adjuncts, and a positive lower genital swab for gonorrhoea supports, but cannot confirm, upper genital tract infection because cervical colonisation does not prove salpingitis.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.