Empyema
Introduction
Introduction Uterine empyema, that is, there is pus accumulation in the uterine cavity. When suffering from acute or chronic endometritis, the cervix is blocked, the drainage is not smooth, and the secretions are retained in the uterus, and uterine empyema can occur. Such as cervical malignant tumor, severe chronic cervicitis, senile vaginitis, or cervical electrocautery, freezing or coning, may cause cervical stenosis, poor drainage and lead to the occurrence of uterine empyema . A small number of patients with uterine empyema have mild leucorrhea, but can eventually lead to serious diseases such as endometrial cancer, endometrial cancer exudation or tissue necrosis. Western medicine is mainly treated by surgical resection, and traditional Chinese medicine is treated with traditional Chinese medicine such as purulent detoxification. It is precisely because it causes many complications that it has become one of the gynecological diseases that women have to pay attention to.
Cause
Cause
Cervical obstruction caused by acute or chronic endometritis, such as uterine inflammatory secretions can not be outflow or poor drainage, can form uterine empyema.
There are two necessary conditions for the occurrence of this disease:
(1) Pus formation. It can be pus at the beginning, or it can be non-inflammatory effusion, hemorrhage, and then infection.
(2) Neck stenosis atresia. Endometritis is the most direct cause of this disease. In fact, endometritis in young women is not uncommon, but the formation of uterine empyema is rare, because the cervical canal can play a good drainage. In postmenopausal women, the level of estrogen decreases, the cervical atrophy, the secretion of glands is reduced, the function of the cervix and vagina is reduced, and the pathogenic microorganisms are invaded by the vagina, causing adhesion, narrowing or atresia of the neck, eventually leading to the uterine cavity. empyema. Of the 23 patients, 19 had vaginitis, confirming the role of the disease in the development of uterine empyema. Endometrial cancer invading the cervical or cervical cancer can lead to narrowing or atresia of the neck, and then combined infection, making the uterine empyema becomes inevitable. It has also been found that a considerable proportion of patients with uterine empyema have chronic pelvic inflammatory disease, diabetes and/or intrauterine devices, indicating that systemic immune status and local inflammation latency have a related role in the formation of this disease.
Examine
an examination
Related inspection
Obstetric B-laparoscopic
The white blood cell count is elevated and neutrophils are increased.
Other auxiliary inspections:
1. Histopathological examination.
2, B-mode ultrasound examination shows that the uterus is enlarged, there is a liquid dark area in the uterine cavity, and there is a strong light spot inside.
3, laparoscopy, hysteroscopy.
Uterine probe examination Generally, the uterus probe is inserted into the cervix about 1-3 cm, which means that there is a sense of resistance. The most common is about 2 cm. Resistance can vary according to uterine empyema, and only the intrauterine empyema probe is easy to insert. In the case of uterine empyema, the probe must be inserted with a little force in the direction of the uterus. If the tissue is tough and the probe is not easy to insert, do not use it blindly. So as not to cause uterine perforation. After the probe enters the uterine cavity, the fan can be swept left and right to sweep the official cavity to test the size of the uterine cavity and the extent of adhesion. A severely adherent person may feel a narrow tube in the uterine cavity, and the probe has a small range of motion or cannot be penetrated at all.
Diagnosis
Differential diagnosis
Differential diagnosis of uterine empyema:
Acute endometritis: Uteritis is one of the inflammations of the pelvic genital organs. It is a common disease in women. Inflammation can be limited to one site, or several sites can occur at the same time. In clinical cases, it is more common in the latter case. Acute inflammation may cause serious consequences such as diffuse peritonitis and sepsis, resulting in septic shock.
Acute cervicitis (acute cervicitis): less common than chronic cervicitis, mostly in puerperal infection or infectious abortion. Trichomonas vaginalis, mold and gonorrhea infections are often accompanied by acute cervicitis. Increased vaginal discharge is the most common and sometimes the only symptom of acute cervicitis, often purulent. Because cervicitis often coexists with urethritis, cystitis or acute vaginitis, acute endometritis, etc., other symptoms of cervicitis are often concealed, such as varying degrees of lower abdomen, lumbosacral pain and bladder irritation. . In acute gonococcal cervicitis, there may be varying degrees of fever and leukocytosis.
Infections caused by various pathogens can express secretions of different traits, sometimes can be identified by visual inspection. Details of vulvar inflammation and vaginal inflammation can be found, but accurate diagnosis should still be taken for smear or culture of cervical secretions for treatment.
