pelvic inflammatory disease
Introduction
Introduction to pelvic inflammatory disease The inflammation of the female pelvic genitalia and its surrounding connective tissue and pelvic peritoneum is called pelvic inflammatory disease, which mainly includes endometritis, salpingitis, fallopian tube ovarian abscess, pelvic peritonitis, pelvic abscess, etc., which can occur at one or several places at the same time. It is one of the common diseases of women. Because of the fallopian tubes, the ovaries are collectively called attachments, and the inflammation of the fallopian tubes often affects the "near neighbor" ovaries. Therefore, there is also the name of annex inflammation. Acute pelvic inflammatory disease caused by acute pelvic inflammatory disease is postpartum or abortion infection, postoperative intrauterine surgery, infection, poor menstruation, direct inflammation of adjacent organs, acute pelvic inflammatory disease can cause acute endometritis and acute Uterine myositis, acute salpingitis, tubal empyema, fallopian tube ovarian abscess, acute pelvic connective tissue inflammation, acute pelvic peritonitis, sepsis and sepsis. Chronic pelvic inflammatory disease is often not treated completely for acute pelvic inflammatory disease, or the patient's physical condition is poor, and the course of disease is delayed. It can cause chronic salpingitis and hydrosalpinx in the body, tubal ovarian inflammation and fallopian tube ovarian cyst, chronic pelvic connective tissue inflammation. . basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of transmission: some pathogens spread through sexual contact Complications: irregular menstruation, pelvic fluid, acute diffuse peritonitis, septic shock, female infertility
Cause
Cause of pelvic inflammatory disease
Postpartum or abortion infection (30%):
Acute pelvic inflammatory disease caused by acute pelvic inflammatory disease is postpartum or abortion infection, postoperative intrauterine surgery, infection, poor menstruation, direct inflammation of adjacent organs, acute pelvic inflammatory disease can cause acute endometritis and acute Uterine myositis, acute salpingitis, tubal empyema, fallopian tube ovarian abscess, acute pelvic connective tissue inflammation, acute pelvic peritonitis, sepsis and sepsis.
Physical differences (20%):
Chronic pelvic inflammatory disease is often not treated completely for acute pelvic inflammatory disease, or the patient's physical condition is poor, and the course of disease is delayed. It can cause chronic salpingitis and hydrosalpinx in the body, tubal ovarian inflammation and fallopian tube ovarian cyst, chronic pelvic connective tissue inflammation. .
Pathogen infection (35%):
Mainly caused by pelvic inflammatory pathogens Staphylococcus, Escherichia coli, anaerobic bacteria, sexually transmitted pathogens (such as gonococcus, Chlamydia trachomatis, Mycoplasma, herpes virus).
Prevention
Pelvic inflammatory disease prevention
1, gynecological examination, childbirth, abortion, abortion, pay attention to cleanliness, utensils and equipment should be strictly disinfected to prevent infection.
2, should pay attention to the health of sexual life, both husband and wife should clean the vulva, to prevent pathogens such as bacteria, mold, trichomoniasis and other pathogens into the vagina, and then cause pelvic inflammatory disease, sexual life within 60 days of menstruation and postpartum.
3, usually clean the vulva, change underwear frequently, often maintain the hygiene of the vulva, while strengthening nutrition, pay attention to rest, regulate emotional, appropriate exercise, enhance physical fitness and disease resistance.
Complication
Pelvic inflammatory disease Complications, irregular menstruation, pelvic fluid, acute diffuse peritonitis, septic shock, female infertility
Acute pelvic inflammatory disease is fatigued, sexual intercourse and pre-menstrual aggravation, severe cases of irregular menstruation, infertility and other complications, chronic pelvic inflammatory disease common complication of pelvic fluid.
There are many causes of dysmenorrhea. Pelvic infection is one of the important reasons. Severe cases may cause diffuse peritonitis, septic shock and other serious consequences. The lighter people will not heal for a long time. Repeated attacks will cause pain to the patients and affect women's physical and mental health.
Symptom
Symptoms of pelvic inflammatory disease Common symptoms Chronic pelvic pain vaginal discharge increased lumbosacral pain abdomen tenderness dysmenorrhea anal bulge female lumbar pain follicular cyst tubal adhesion ovarian cyst
1. The symptoms of acute pelvic inflammatory disease are characterized by acute onset, severe illness, abdominal pain, fever, chills, headache, loss of appetite. The patient is found to have acute illness, high body temperature, fast heart rate, and muscle tension in the lower abdomen. Tenderness and rebound tenderness, pelvic examination: There are a lot of purulent secretions in the vagina, there is obvious tenderness in the vagina, tenderness in the uterus and double attachments, rebound pain, or thickening of one side attachment.
2. The main manifestations of chronic pelvic inflammatory disease are:
(1) Lower abdomen bulge, pain and soreness in the lumbosacral region, sometimes accompanied by anal bulge discomfort, often tired, after sexual intercourse and before and after menstruation.
(2) due to pelvic congestion, patients may have increased vaginal discharge, increased menstruation, dysmenorrhea and other symptoms. When the ovarian function is damaged, there may be menstrual disorders, and the tubal adhesions may cause infertility.
(3) The systemic symptoms are not obvious, sometimes there may be low fever, susceptibility to fatigue, and longer duration of the disease, some patients may have symptoms of neurasthenia.
(4) In the case of gynecological examination, if it is an attachment inflammation, thickened strips or patches may be found on one or both sides of the uterus, accompanied by mild tenderness, such as the formation of hydrosalpinx or Tubal cysts can touch the cystic mass; if it is pelvic connective tissue inflammation, the uterus can be thickened on both sides and have different degrees of tenderness.
Examine
Pelvic inflammatory disease
1. Direct smear of secretions.
2. Pathogen culture.
3, after the puncture.
4, ultrasonic examination: mainly B-type or gray-scale ultrasound scanning, filming.
5, laparoscopic examination: laparoscopic examination can not only confirm the diagnosis and differential diagnosis, but also the initial determination of the degree of pelvic inflammatory disease.
6, male partner's examination: This is helpful for the diagnosis of female pelvic inflammatory disease, may be taken with male urethral secretions for direct smear staining or culture of gonorrhea, if found positive, it is a strong evidence, especially in asymptomatic Or mild symptoms, or you can find more white blood cells, if you are treated with men with all PID patients, whether they have urethritis symptoms, it is obviously very meaningful to reduce recurrence.
Diagnosis
Diagnosis and diagnosis of pelvic inflammatory disease
diagnosis
Acute pelvic inflammatory disease has a history of acute infection, lower abdominal pain, muscle tension, tenderness and rebound tenderness, accompanied by rapid heart rate, fever, a large amount of purulent secretions in the vagina, high fever, headache, chills, loss of appetite, when the condition is serious, A large number of yellow and white with taste, abdominal pain, tenderness, waist pain, etc.; there are nausea, bloating, vomiting, diarrhea, etc. in peritonitis; when there is puff formation, there may be lower abdominal mass and local compression stimulation symptoms, the mass is located There may be dysuria in the front, frequent urination, dysuria, etc., and the mass may cause diarrhea at the back.
Chronic pelvic inflammatory disease systemic symptoms are sometimes low fever, susceptible to fatigue, some patients have neurasthenia symptoms due to long course of disease, such as insomnia, lack of energy, general discomfort, etc., lower abdomen bulge, pain and lumbosacral pain, often tired, After sexual intercourse, before and after menstruation, due to chronic inflammation caused by pelvic congestion, menorrhagia, ovarian dysfunction will occur menstrual disorders, tubal adhesions can cause infertility.
Differential diagnosis
The main differential diagnosis of acute pelvic inflammatory disease: acute appendicitis, ectopic pregnancy, ovarian cyst torsion, etc.; the main differential diagnosis of chronic pelvic inflammatory disease: endometriosis and ovarian cancer.
