Does acute pelvic peritonitis require surgery?

As modern life becomes more and more tense and the environment becomes more and more harsh, the incidence of pelvic peritonitis is getting higher and higher. It is a group of diseases caused by inflammation of the female upper reproductive tract, which seriously affects people's health. Therefore, the treatment of this disease is particularly important. Below I will introduce in detail whether acute pelvic peritonitis requires surgical treatment. I hope it will be useful to everyone.

Does acute pelvic peritonitis require surgery?

Ineffective drug treatment: If the body temperature of a fallopian tube, ovarian abscess or pelvic abscess does not drop after 48 to 72 hours of drug treatment, or the patient's poisoning symptoms worsen or the mass increases, surgery should be performed promptly to avoid abscess rupture.

Abscess persists: The condition improves after drug treatment and the inflammation is controlled for several days (2 to 3 weeks). If the mass has not disappeared but has become localized, it should be surgically removed to avoid another acute attack in the future or the formation of chronic pelvic peritonitis.

Abscess rupture: Sudden worsening of abdominal pain, chills, high fever, nausea, vomiting, abdominal distension, refusal to press the abdomen, or signs of toxic shock should be suspected of abscess rupture. If abscess rupture is not diagnosed and treated in time, the mortality rate is high. Therefore, once abscess rupture is suspected, laparotomy should be performed immediately while treating with antibiotics.

The surgery can be performed by abdominal surgery or laparoscopic surgery according to the situation. The scope of the surgery should be comprehensively considered based on the scope of the lesion, the patient's age, and the general condition. The principle is to remove the lesion. Young women should try to preserve ovarian function and use conservative surgery as the main method; for older women, those with bilateral adnexal involvement or repeated adnexal abscesses, total hysterectomy and bilateral adnexectomy should be performed; the scope of surgery for extremely weak and critically ill patients should be determined according to the specific situation. If the pelvic abscess is located low and protrudes into the posterior vault of the vagina, it can be drained through the vagina and antibiotics can be injected at the same time.

In summary, pelvic peritonitis is a difficult disease to cure. Since there are many pathogenic factors, there are also many treatment methods. Based on my many years of medical experience, I recommend surgical treatment for patients with severe illness, and I recommend using an antibacterial spectrum that covers anaerobic bacteria for patients with mild illness. As long as the above points are achieved, this disease can be treated well.