Pelvioperitonitis in gynecology - causes, diagnosis, treatment and symptoms

Pelvioperitonitis is an inflammatory disease of the pelvic peritoneum. Without timely treatment, this pathology can lead to dangerous consequences. Pelvioperitonitis in gynecology - what it is and what threatens it, we will consider in the article.

Disease Description

Pelvioperitonitis is a disease that occurs against the background of infectious processes in the lower part of the peritoneum. May affect any pelvic organs. It is noteworthy that the disease can develop both in older women and in young girls. Without complex treatment, it can provoke dangerous complications.

Classification

This disease is usually classified according to several parameters.

The following types are distinguished:

• Primary. In this case, the infection penetrates immediately into the pelvic area. This happens with gynecological manipulations or injuries of the lower abdomen.
• Secondary. It occurs due to other inflammatory processes in the body.

According to the prevalence of pelvic peritonitis in gynecology, it is customary to distinguish:

• Partial (limited). The inflammatory process in this case covers a limited area near the source of the pathological process.
• Diffuse. The most dangerous type in which inflammation affects the entire pelvic area. Often a partial complication.

According to the clinical picture, the disease is divided into the following types:

• Acute. It occurs most often. Symptoms that occur suddenly are very pronounced.
• Chronic. It is lethargic, the symptoms are poorly expressed. If the immune system is malfunctioning, it can become aggravated. This type of disease is often caused by untreated acute pelvioperitonitis. It requires careful treatment, as it can cause dangerous consequences, because in the chronic course of the disease, the inflammatory process is constantly present in the body.

Many experts identify several stages of the development of the disease:

• Initial. Infectious agents first enter tissues, affecting cells and causing swelling.
• Serous. Affected cells begin to secrete serous fluid. With a progressive inflammatory process, serous effusion is released in large quantities. It is characteristic of viral inflammation.
• Purulent. A dangerous stage of the development of the disease. It arises as a result of the primary defeat of the body by bacteria or the attachment of the bacterial flora to an existing fungal or viral process. This stage can cause serious complications, especially in the absence of timely treatment.

It is also worth noting the varieties of the inflammatory process. These include:

• Exudative. With this type of inflammation, a large amount of effusion forms in the pelvic area.
• Adhesive pelvioperitonitis in gynecology, what is it? This type of disease is the most severe, in which a sticky glue-like exudate is formed very quickly. It is dangerous because it glues together the pelvic organs, forming a large number of adhesions. They, in turn, can provoke pain in the pelvic area, obstruction of the tubes and infertility. This type is also called plastic pelvioperitonitis in gynecology.

Causes of the disease

The main cause of pelvic peritonitis in gynecology is the penetration of infectious agents into the pelvic area. This can occur due to various factors. Consider the most common of them.

• Surgical or gynecological intervention - abortion, hysteroscopy, insertion or removal of an intrauterine device, curettage of the uterine cavity, damage to the vaginal vault. You can also make an infection with a gynecological examination.
• Intestinal obstruction.
• Ruptures of the ovaries, tumors, torsion of the legs of the cyst.
• The spread of infection due to diseases such as adnexitis, gonorrhea, salpingitis, appendicitis, genital tuberculosis and others.
• Purulent inflammatory process in the uterus or other organs of the female genital area.
• Indiscriminate sexual intercourse.
• Poor personal hygiene.
• Stress.
• Hypothermia.
• Decreased immunity. This may include common causes of this - the period of epidemics of respiratory infections, the period after the disease, vitamin deficiency and others. But also a decrease in the body's defenses can be a consequence of a blood disease, AIDS or HIV.

Separately, it is worth noting the development of the disease in the postpartum period. It develops rapidly and almost immediately after childbirth. The infection enters the abdominal cavity through the lymph from the uterus or genital tract. This happens if a woman had an infectious disease already during pregnancy.

Symptoms

With pelvic peritonitis, symptoms of acute and chronic type will differ from each other in severity.

The disease begins with an acute stage and has the following symptoms:

• General malaise.
• Severe pain in the lower abdomen. A woman is not able to answer exactly where she is localized, since she can give to the lower back, rectum or inguinal region. Pain is present in the entire lower abdomen. Strengthens with physical activity, with light pressure or gynecological examination.
• High temperature, which can reach 39 degrees, with all signs of intoxication.
• Nausea and vomiting.
• Tachycardia.
• Violation of the stool and urination. This may indicate an infection of neighboring organs - the intestines or the bladder.
• Profuse sweating.
• Bloating.
• Plaque on the tongue.
• Low pressure.
• The abdomen is not involved in the breathing process.
• Atypical discharge.

When observing the above symptoms, you should consult a doctor as soon as possible, since only a specialist based on the results of diagnostic measures can make an accurate diagnosis.

The disease is easily confused with other pathological processes. For example, the symptoms of pelvioperitonitis and parametritis are very similar, but can also be signs of appendicitis or ectopic pregnancy.

In chronic plastic pelvic peritonitis in gynecology, the symptoms will not be as pronounced as in acute. The following conditions may bother a woman:

• A slight increase in body temperature.
• General malaise.
• Aching in the lower abdomen.
• Violation of urination and stool.

Many patients take these signs for manifestations of cystitis and choose the wrong therapy for treatment. For this reason, the inflammatory process continues to develop, forming ever new adhesions.

Diagnostics

Due to the fact that the signs of pelvioperitonitis are similar to the manifestations of other equally dangerous diseases, a number of diagnostic measures must be taken to make an accurate diagnosis. These include:

• Admission to the gynecologist, which collects information about chronic diseases, infections, localization of pain.
• Palpation of the lower abdomen. With pelvic peritonitis, a woman will feel severe pain.
• Gynecological examination with mirrors. This method may not be sufficiently informative due to severe pain.
• Analysis of urine and blood.
• Ultrasonography.
• Roentgenography.
• Taking a smear.
• Puncture of the peritoneum. The procedure is carried out through the back wall of the vagina.
• Sowing fluid to determine the pathogen of the inflammatory process.
• In especially complicated cases, a laparoscopy procedure is recommended.
• When confirming the diagnosis, consultation with a surgeon is required.

Treatment

Self-treatment of pelvioperitonitis in gynecology is prohibited. The therapy is carried out in a hospital and can be performed by two methods - conservative and surgical. Symptoms play an important role in the choice of a method for treating pelvioperitonitis in gynecology. After all, their manifestation helps to determine the stage of development of the disease and to choose the most effective treatment program.

First of all, you need to stop the pain. To do this, cold is applied to the lower abdomen. This allows you to relieve pain and prevents the further spread of infection. Prior to confirming the diagnosis, it is not recommended to use any pain medication, since their effect affects the manifestation of symptoms. Also, the patient needs bed rest with a raised head.

Conservative therapy

Conservative treatment involves the use of medications and is used in cases where the disease has not yet reached a critical stage. The drugs used in this case include:

• Antibiotics, which are the basis of the whole treatment. For example, Amoxicillin, Ceftriaxone, Dipril. But for the best treatment effectiveness, it is recommended to carry out bacterial culture for sensitivity to antibacterial agents.
• Diuretics - Furosemide.
• Drugs that reduce intoxication and are administered through droppers - for example, saline, glucose.
• Antihistamines - "Loratadin", "Suprastin" and others.
• Anti-inflammatory - Nimesulide, Naproxen, Diclofenac.
• Painkillers - Promedol, candles with belladonna.
• If necessary, anticoagulants are prescribed.
• Preparations to maintain the cardiovascular system.
• Supportive therapy, including the intake of vitamin complexes.
• Immunostimulating drugs.

After the removal of the symptoms of acute pelvic peritonitis in gynecology, physiotherapy is prescribed to prevent the formation of adhesions. These include:

• electrophoresis;
• laser therapy;
• ultrasound therapy;
• phonophoresis;
• massage;
• Exercise therapy.

Anti-adhesion therapy is also recommended, which includes the use of enzyme-containing drugs - "Lidaza", "Hyaluronadase"

Surgery

If, when determining the cause of the symptoms, the diagnosis of pelvioperitonitis revealed the presence of a purulent process in the pelvic area, surgical intervention may be required. Also, this treatment method is used in the absence of effectiveness from antibacterial therapy, with a sharp deterioration in the patient's condition or with the formation of a large number of adhesions. Surgical treatment can be carried out in the following ways:

• Puncture of the abdominal cavity, in which antibacterial and anti-inflammatory drugs are introduced into the body using a special device (punctate). As a rule, about ten procedures may be required. The recovery period is short.
• Laparoscopy. In this case, the risk of postoperative complications is minimal.
• Abdominal surgery. It is carried out as a last resort, when the infectious focus reaches total size. With this method, the risk of complications is high.

Consequences and Complications

Pelvioperitonitis in gynecology with timely treatment is completely cured and does not leave negative consequences. But if the disease was not diagnosed immediately and treatment was not prescribed, the consequences can be very dangerous.

• Infertility.
• Ectopic pregnancy.
• Purulent fusion of the pelvic organs. This happens when the purulent process affects the pelvic organs. In this case, an emergency operation is performed, in which the affected organs can be removed. For example, ovaries, tubes and uterus.
• The spread of inflammation. With pelvic peritonitis, the infectious focus is in the pelvic area. But without treatment, the inflammatory process can go into the abdominal cavity.
• Sepsis. Infection with blood flow can enter other organs and tissues. This is the most dangerous consequence of the disease, as it can be fatal.

Pelvioperitonitis in children

Girls are also affected by this disease. Usually pathology is detected at the age of three to seven years. The infection enters the peritoneum from the genitals. This happens because at a young age the protective environment in the vagina has not yet fully formed.

Pelvioperitonitis in girls can develop sharply, with the manifestation of obvious symptoms - pain, fever and others. But also signs of the development of the disease can resemble SARS. A distinguishing factor will be vaginal discharge.

If you suspect an inflammatory process, you must immediately take the child to the pediatrician and pediatric gynecologist. With an understanding of the causes and symptoms of pelvic peritonitis, diagnosing is not difficult.

Prevention

Pelvioperitonitis is a disease whose likelihood can be minimized. It is enough to carry out the prevention of acute inflammation of pelvic peritonitis. These include:

• A systematic visit to the gynecologist.
• Careful personal hygiene.
• The right way of life, including a balanced diet, quitting smoking and alcohol.
• Moderate physical activity. Sexual culture excluding casual sexual intercourse.
• The use of contraception.
• Timely detection and treatment of gynecological diseases, especially if they are associated with the development of the inflammatory process.
• Avoidance of abortion and curettage.
• A complete cure for STDs, since, in most cases, they provoke the development of pelvioperitonitis.
• Treatment of chronic diseases of an infectious nature - tonsillitis, caries and others.
• Exclusion of hypothermia.
• Timely registration during pregnancy and delivery of all necessary tests.
• Timely extraction of the intrauterine device.

Conclusion

Despite the fact that pelvic peritonitis in gynecology and obstetrics can cause dangerous consequences, timely diagnosis and treatment minimizes the risk of complications. The main thing is, if any of the above symptoms occurs, consult a doctor as soon as possible, who will prescribe the necessary tests and procedures. In any case, therapy will be aimed at removing the focus of infection and preserving the childbearing function of the woman.