Main »
Gynecology
» Pelvioperitonitis - Diagnosis, Treatment
19:43
Pelvioperitonitis - Diagnosis, Treatment
Pelvioperitonitis - Diagnosis, Treatment
Pelvioperitonit - inflammation of the pelvic peritoneum - is developing a second lesion in the uterus, fallopian tubes and ovaries. The predominant route of penetration of microorganisms in the peritoneal cavity - through the fallopian tubes. In addition, the infection can come lymphogenous and hematogenous routes, as well as the contact (eg, appendicitis).
There are:
sero-fibrous
purulent pelvioperitonit.
The first of these has a more favorable course and a tendency to limit the process beyond the pelvis. This contributes to the development of adhesions between the parietal peritoneum pelvis, uterus, uterus, and omentum, loops of small bowel, sigmoid colon and bladder. When purulent pelvioperitonit delimitation process is much slower, is accompanied by leaking pus in the Douglas area and the formation of Douglas-abscesses.
Clinic pelvioperitonitis
The clinic is typical of acute inflammation: febrile temperature, severe pain in lower abdomen, bloating, protective muscle tension anterior abdominal wall, with purulent pelvioperitonit observed positive symptom SHCHetkina-Blumberg. Intestinal peristalsis is weakened, may be delayed stool and gas, tongue dry, marked nausea and vomiting. The blood sedimentation rate accelerated sharply, expressed a high neutrophilic leukocytosis with a left shift. The patient's condition serious, but with proper and full treatment occurs in a significant improvement within 1-2 days.
Diagnosis pelvioperitonitis
At gynecological examination in the early days of the disease has only been stiff and sore back arch, where the protrusion appears then as a result of accumulation of exudate.
Treatment pelvioperitonitis
Treatment - only in a hospital. The patient is prescribed strict bed rest, rest, cold in the lower abdomen, broad-spectrum antibiotics or fluoroquinolone drugs in combination with metronidazole. Infusion-detoxification therapy is administered in an amount corresponding to the severity of the patient. In the formation of Douglas-draining abscess is shown by a puncture or colpotomy followed by the introduction of antibiotics into the cavity.
