bloody discharge
Introduction
Introduction Common in the prodromal period of malignant granuloma, for general cold or sinusitis, intermittent nasal obstruction, with watery or bloody secretions, or odor. If the vaginal bloody secretions may be related to endometritis and cervicitis. Bloody secretion refers to a bloody liquid in the secretions, mostly due to local mucosal damage, small blood vessel rupture caused by less bleeding, and longer duration. Bloody secretions from the nose are common in the prodromal period of malignant granuloma. Vaginal bloody secretions may be associated with endometritis, cervical erosion, and cervical cancer. The breast is accompanied by bloody milk, and the possibility of considering cancer is large.
Cause
Cause
Bloody secretions from the nose are common in the prodromal period of malignant granuloma.
Vaginal bloody secretions may be associated with endometritis and cervicitis.
Examine
an examination
Related inspection
Leucorrhea check gynecological examination
First, the diagnosis of malignant granuloma:
1, pathological biopsy presents chronic non-specific granulomatous lesions, if the appearance of heterologous reticulocytes or mitotic phase can diagnose the disease.
2, laboratory tests: white blood cell count is low, erythrocyte sedimentation rate is accelerated; immunoglobulin levels are high, no special discovery of bacteria, fungi and virus culture.
3, CT scan of the tomographic X-ray film.
Second, the diagnosis of endometritis
Laboratory examination: It can be used for blood culture and uterine secretion culture and drug sensitivity test, which can be clearly diagnosed and used for therapeutic use.
B-ultrasound examination: B-ultrasound for the initial diagnosis of intrauterine state, the results of the test combined with clinical symptoms and laboratory results to diagnose hand endometritis.
In vivo scan: In the absence of obvious symptoms, an in vivo scan is required. Using a scanner to examine a patient can also determine the method and method of treatment.
Leucorrhea check: You can rule out whether you have vaginitis. The time and effect of treatment depends on the sensitivity of your body to receive drugs.
Blood: In acute endometritis, the total number of peripheral white blood cells and neutrophils increased. Diagnostic curettage: suspected chronic endometritis, can be diagnosed by curettage after three days of antibiotic-controlled inflammation. Pathological examination to confirm the diagnosis, but also play a certain therapeutic role.
Third, the diagnosis of cervicitis:
1. Typical clinical manifestations.
2. Gynecological examination: acute inflammation can be seen in cervical congestion and edema, or erosion, there is a purulent discharge of the white tube neck discharge, when you touch the cervix can have pain. Chronic cervicitis can be seen in the cervix with varying degrees of erosion, hypertrophy, polyps, glandular cysts, valgus and other manifestations, or see a purulent discharge in the cervix, palpation of the cervix is hard. If it is cervical erosion or polyps, there may be contact bleeding.
3. Cervical scrapings show Papphire II.
4. If the condition is serious, a cervical biopsy can be performed to confirm the diagnosis.
5. Cervical erosion or polyps and early cervical cancer meat are more difficult to identify, the latter tissue is hard, brittle, easy to bleed, must rely on the official cervical scraping to find cancer cells, if necessary, do colposcopy and cervical tissue biopsy for identification.
Diagnosis
Differential diagnosis
First, the differential diagnosis of malignant granuloma:
According to the characteristics of malignant granuloma and pathological changes, it can be classified into two categories, which need to be identified.
1. Tumor-like type: The lesions are mostly in the nose, and also in the upper jaw, the pharynx, and then the nose. The lesion is mainly located in the midline of the face and the upper respiratory tract. It is mainly caused by granulomatous ulcer and necrosis. It is very destructive and can invade bone and cartilage, resulting in disfigurement. Most patients with advanced disease died of major bleeding or failure, and there was no arterial inflammation in the autopsy material. The pathological changes of this disease are quite different, mainly found in the following four types:
(1) Non-specific inflammatory granulation tissue contains various forms of inflammatory cells;
(2) Non-specific inflammatory granulation tissue contains a large number of tissue cells;
(3) Non-specific inflammatory granulation tissue has obvious necrosis;
(4) Non-specific inflammatory granulation tissue contains many giant cells. The above four types are mostly mixed, and often are mainly lymphocytes, mixed with a considerable number of plasma cells and a number of tissue cells. These cells have a tendency to infiltrate around the blood vessels centered on the blood vessels. Although these cells have moderate atypia, they cannot be diagnosed as malignant tumors. Although the pathological changes of Wegener granuloma are also non-specific granulomas, they are characterized by multinucleated giant cells and necrotizing vasculitis. This is a pathological change of malignant granuloma and Wegener granulomatosis, although it is also a non-specific granuloma, but it is characterized by There are multinucleated giant cells and necrotizing vasculitis, which is the differential diagnosis criteria for malignant granuloma and Wegener granulomatosis.
2, allergic type (autoimmune type) Wegener granuloma belongs to this type, can be divided into two types: localized and systemic. Mainly due to vascular allergic inflammation, in addition to multiple granuloma, more intractable ulcer necrosis. It can be limited to the upper respiratory tract, and can also affect the lungs and organs of the body. Invasion of the lungs presents multiple nodules, often with cavities, involving renal necrosis, glomerulonephritis, lesions can cause systemic vascular damage, fibrous exudate and granulation tissue in the middle of the blood vessels. Wegener's granuloma ulcers are painstakingly carried out in the body and involve organs such as the nose, upper jaw, pharynx, larynx, trachea, kidney, spleen, adrenal gland and lungs, which can die from systemic failure and uremia.
Second, endometritis needs to be identified as follows.
Acute endometritis: Sudden lower abdominal pain, increased vaginal discharge, and fever, increased pulse rate. During the gynecological examination, it was found that the cervix had a large amount of pus, bloody secretions spilled out, the cervix was painful, and the uterus was slightly larger.
Chronic endometritis: Women often feel lower abdominal pain or bulge, pain in the lumbar muscles, increased vaginal discharge, watery, pale yellow or purulent, bloody. And will be accompanied by irregular vaginal bleeding or menstrual extension, dysmenorrhea, amenorrhea. The uterus is spherical, soft, tender, and can be excreted with bloody and purulent secretions.
Third, cervicitis needs to be identified as follows.
Chronic cervicitis: Chronic cervicitis is a chronic erosive or proliferative inflammation of the uterine neck, mostly caused by acute cervicitis, or no obvious acute phase. Chronic cervicitis is a common and frequently-occurring disease. With age, the incidence rate is significantly increased, and unmarried women are rare. Mainly due to the stimulation of the cervix by menstruation and sexual life. It is equivalent to the category of "taking down the disease" in Chinese medicine.
Acute cervicitis: Acute cervicitis occurs mostly in puerperal infections or infective abortions. Trichomonas vaginalis, mold and gonorrhea infections are often accompanied by acute cervicitis.
