Post Date November, 16 2024
Pelvic Peritonitis is female gynecological inflammation, which also occurs in our daily life. After illness, patients will not only have abdominal pain, but also have fever.
Symptoms of pelvic Peritonitis
1. High fever: Women who do not pay attention to personal hygiene in the genital area for a long time have frequent sexual intercourse, which can cause gynecological diseases during menstruation. Generally speaking, because there are fewer primary cases of pelvic Peritonitis, the inflammation of acute pelvic inflammation is mostly a typical symptom caused by the accumulation of medical history. Generally, patients have chills and high fever, while a few have a body temperature above 40 ° C, accompanied by symptoms of nausea, vomiting, and worsening during activity.
2. Abdominal pain: severe infection occurs in pelvic organs. Pathogens can spread directly through the bloody or Lymphatic system, and even affect the pelvic peritoneum, causing pelvic Peritonitis. At the same time, this inflammation can also coexist with other pelvic infections. In particular, salpingitis often presents spasmodic abdominal pain, abdominal wall tension, rigidity or plate-like abdomen. It is a long-term persistent pain. Urinary system is also obstructed. When urinating and defecating, I feel pain, diarrhea and constipation.
3. Emotional impatience: In severe cases, patients may experience impatient systemic exhaustion. Symptoms such as unclear consciousness, delusions, and coma appear in work and life.
4. Severe symptoms: In severe cases, typical symptoms include shock, decreased blood pressure, grayish white color, dry tongue, and cold sweat. The patient's body exhibits symptoms such as collapse, heart failure, and pulmonary edema. In the chronic stage, it can spread to the greater omentum, and the surface of the intestinal mucosa is uneven, with blocks of different sizes fixed by pressure pain. Based on the above symptoms and experimental examination, the number of white blood cells and neutrophils is high, and the erythrocyte sedimentation rate is significantly increased.
Pelvic Peritonitis examination
1. Laboratory diagnosis: Abdominal puncture and posterior fornix puncture can extract fluid, mostly pale yellow, pale bloody fluid, yellow exudate, or pus. It can be sent to the laboratory for examination or cultivation of bacteria. The number of white blood cells and neutrophils in the surrounding blood increases, and the erythrocyte sedimentation rate accelerates. Cervical secretions and blood culture can cultivate pathogenic bacteria.
2. Ultrasound examination: When an abscess forms, a B-type ultrasound examination can detect the tumor, which is mostly irregular in outline and has dense echoes around it. The internal area is anechoic.
3. Women's examination: changes in vaginal mucosal congestion, purulent discharge from the cervix, and obvious tenderness in the dome during double diagnosis. Anal examination can contact the fluctuating and swollen parts of the anterior wall of the rectum.
4. Laparoscopic examination: if it is not diffuse Peritonitis, the patient's general condition is good. Laparoscopic examination can be performed in patients with pelvic Peritonitis, suspected pelvic Peritonitis and other acute abdomen. Laparoscopic examination can not only make a clear diagnosis and differential diagnosis, but also make a preliminary judgment on the extent of pelvic Peritonitis.
5. Posterior foramen puncture: one of the most commonly used and valuable diagnostic methods for pelvic Peritonitis in gynecological acute abdomen. Through puncture, the contents of the abdominal cavity and the uterine rectal fossa obtained, such as normal abdominal fluid, blood (fresh, old, clotting, etc.), purulent secretions, and pus, further clarify the diagnosis and require mirror examination and culture of the puncture material.
Diagnosis of pelvic Peritonitis
1. Minimum diagnostic criteria:
(1) Uterine tenderness
(2) Attachment tenderness
(3) Cervical pain
Patients with lower abdominal tenderness accompanied by symptoms of lower reproductive tract infection have a significantly increased likelihood of diagnosing PID.
2. Additional diagnostic criteria: 0.9% NaCl coating of cervix or Vaginal discharge with mucopurulent secretion of vagina with body temperature over 38.3 ℃ saw the increase of Erythrocyte sedimentation rate of a large number of white blood cells, the rise of blood c-reactive protein, and the laboratory proved that Neisseria gonorrhoeae and Chlamydia were positive.
3. Special diagnostic criteria: vaginal ultrasound and magnetic resonance imaging with histological evidence of Endometritis found in endometrial biopsy showed tubal wall thickening, intraluminal effusion, and laparoscopy with or without pelvic effusion or tubo ovarian abscess showed abnormal findings consistent with PID.
