Diagnostic criteria for female pelvic peritonitis

Pelvic peritonitis is a common disease among women of childbearing age, and it is very harmful to women. Therefore, women who have symptoms of pelvic peritonitis such as abnormal vaginal discharge and lower abdominal pain need to go to the hospital for diagnosis in time so that they can receive timely treatment. So what are the examination methods for pelvic peritonitis? Which examination methods can effectively diagnose pelvic peritonitis?

1. Direct smear of secretions: Take samples of vaginal and cervical secretions, urethral secretions, or peritoneal fluid for direct thin-layer smear.

2. Laparoscopic examination: If it is not diffuse peritonitis and the patient is generally in good condition, laparoscopy can be performed on patients with pelvic peritonitis or suspected pelvic peritonitis and other acute abdomen. It can not only confirm the diagnosis and differential diagnosis, but also make a preliminary judgment on the degree of the disease.

3. Ultrasound examination: This mainly involves B-type or grayscale ultrasound scanning. This technology has an 85% accuracy in identifying masses or abscesses formed by adhesions of the fallopian tubes, ovaries and intestines, but mild or moderate pelvic peritonitis is difficult to show characteristics in B-type ultrasound images.

4. Posterior fornix puncture: This is one of the most commonly used and valuable diagnostic methods for gynecological acute abdomen. Through puncture, if the abdominal cavity contents or uterine rectal fossa contents are normal, the peritoneal fluid, blood, purulent secretions or pus can further clarify the diagnosis, and microscopic examination and culture of the punctured material are even more necessary.

5. Pathogen culture: The specimens are from the same sources as above. They should be inoculated into Thayer-Martin culture immediately or within 30 seconds, and then cultured in a 35°C incubator. Bacterial identification is performed by glycolysis for 48 hours. The new relatively rapid chlamydial enzyme assay replaces the traditional chlamydia detection method, and mammalian cell culture can also be used to detect Chlamydia trachomatis antigens.

6. Examination of male partners: This is helpful for the diagnosis of female pelvic peritonitis. The urethral secretions of the male partner can be directly smeared or cultured for gonorrhea. If positive, it is a strong evidence, especially in patients with no symptoms or mild symptoms. Or more white blood cells can be found. If all male partners of PID patients are treated, regardless of whether they have symptoms of urethritis, it is obviously very meaningful to reduce recurrence.