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Objective: To evaluate the sensitivity and specificity of vaginal sonography in the detection of endometrial abnormalities in patients with postmenopausal bleeding (PMB).Methods: In a prospective study, 54 patients with PMB were examined with vaginal ultrasonography prior to dilatation and curettage. The mean endometrial thickness was compared with the histopathological results. A cutoff value of 5 mm was prospectively chosen to evaluate the sensitivity and specificity of this method.Results: The calculated sensitivity for the measurement of endometrial thickness as a predictor of endometrial pathology was 89%, and the specificity was 83%. We found carcinoma associated with an endometrial thickness of 6 mm.Conclusions: Although its sensitivity was high, we feel that an endometrial thickness >5 mm should constitute a cause for concern but not a definitive indication of pathology. Thus we believe that, at this point, the role of vaginal sonography as an aid in determining which women with PMB should undergo curettage has yet to be determined. 0 1996 John Wiley & Sons, Inc.

Adnexal torsion in premenarchal patients is rare, presents similarly to older patients, but involves a normal adnexa in 69% of cases, therefore requiring a high index of suspicion in any premenarchal patient with acute onset abdominal pain.

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