Classical classification of pelviopertonitis distinguish plastic or adhesive pelvioperitonitis and escudative. Plastic pelvioperitonitis is accompanied by clumping of tissues – the formation of adhesions. Accordingly, the escudative type of the disease is characterized by the effusion of the escudata – the release of purulent contents or inflammatory fluid. Depending on the causative agent of the disease, the escudate assumes different types – the disease caused by staphylococcal infection is accompanied by a purulent or serous-purulent escudata, the rod-like flora produces a serous-purulent discharge with a characteristic caloric smell, gonorrhea pelvioperitonitis is accompanied by a purulent-hemorrhagic escudate.
And for gonorrheal pelvioperitonitis, a plastic flow with intense adhesion and fusion of the internal genital organs, omentum and intestine is characteristic.
Acute pelvioperitonitis manifests itself as a high fever reaching 39-40 degrees, accompanied by fever, dizziness and headaches, nausea and vomiting, dry mouth with a white tongue overlaid with the tongue, pale skin with a greyish tinge, exacerbation of facial features. Against the background of general signs of intoxication, the woman feels intense, often throbbing pain in the lower abdomen, painful urination, pressure on the rectum in the absence of stool. As for the symptoms of pelvioperitonitis include unstable blood pressure, a violation of the heartbeat, tachycardia.
For chronic plastic pelvioperitonitis is characterized by a prolonged temperature increase, however, for insignificant indicators – 37 – 37.4 degrees. Dull aching pain, general decrease in vitality, violation of defecation and frequent urge to urinate, which often becomes a causal error of women and attempts to engage in self-medication with the use of drugs from cystitis. As the disease progresses, the adhesion process develops, as a result of which there is an adhesion of the organs with the intestine and the omentum, which subsequently can have an extremely negative impact on the development of pregnancy and the course of labor, even with delivery by cesarean section, the resulting adhesions can cause significant complications in the entry in the uterus.
Pelvioperitonitis is diagnosed during gynecological examination, and, if necessary, additional instrumental and laboratory studies are performed. Because of hyperemia and inflammation, the uterus and ovaries are practically not palpable, in addition, the examination is accompanied by significant intense sensations, especially pronounced with gonorrhea infection. In bimanual examination (one hand of the doctor is in the vaginal vault, and the other on the woman’s abdomen above the pubic part) is revealed by the displacement of the uterus to the front and up, and also the bulging of the vaginal vaults. Laboratory blood tests show an increase in leukocyte count and an increased rate of erythrocyte sedimentation. Ultrasound examines the degree of spread, as well as the effusion in the small pelvis. To identify the pathogen, a puncture of the purulent contents or inflammatory fluid is performed through the vaginal vault or peritoneum.
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