Treatment options for pelvic peritonitis

In principle, the treatment of pelvic peritonitis is to actively eliminate the cause of peritonitis, and thoroughly clean and absorb the pus and exudate in the abdominal cavity, or promote the absorption and localization of exudate as soon as possible. There are many treatments for pelvic peritonitis, such as general therapy, antibiotic treatment, surgical treatment, etc. So, what are the treatments for pelvic peritonitis?

Three treatments for pelvic peritonitis

1. General treatment

All patients should rest in bed and take a semi-recumbent position to facilitate the accumulation of exudate or pus in the pelvic cavity, thereby limiting the inflammation. Adequate nutrition and fluid infusion should be given, and electrolyte disorders and acid-base imbalances should be corrected. Physical cooling can be used when effective. Gastrointestinal decompression can be given for patients with severe abdominal distension. Unnecessary gynecological examinations should be reduced to avoid the spread of inflammation.

2. Antibiotic Treatment

Patients with acute pelvic peritonitis should undergo bacterial culture of cervical secretions or posterior fornix puncture fluid, or blood culture and drug sensitivity test, and select effective antibiotics based on this. When the pathogen is unclear, gentamicin plus metronidazole can be used, which is effective against Escherichia coli and anaerobic bacteria. The specific usage is gentamicin 80,000 U, twice a day, intramuscular injection, 0.2% metronidazole 500 ml once a day, intravenous drip. You can also use 2.4 grams of Ansitrol, add liquid to intravenous drip, once a day, and take Ansitrol tablets 0375 in the evening to enhance the efficacy; in addition, vancomycin B, Clavula, erythromycin, fosfomycin sodium, etc. can all be used. When the results of bacterial culture and drug sensitivity test are detected, it should be decided whether to change the antibiotic based on the results of the drug sensitivity test and the efficacy of the first selected antibiotic. Generally, those with better efficacy can be replaced, but those with insignificant efficacy after 3 to 4 days of medication should be replaced in time.

3. Surgical treatment

1. Incision and drainage: When pelvic peritonitis causes abscess formation and the abscess has reached the pelvic floor, incision and drainage can be performed through the posterior fornix. However, since the abscess is located in the abdominal cavity, drainage can only temporarily relieve symptoms and often cannot cure the disease.

2. Laparotomy to remove the lesion: When a pelvic abscess forms and ruptures, laparotomy can be performed to remove the lesion while controlling the infection with large amounts of antibiotics. This is the most effective and rapid method.

The above is an introduction to the treatment methods for pelvic peritonitis. I hope it will be helpful to you.