What are the diagnostic criteria for pelvic peritonitis?

A disease that is easily induced by female friends is pelvic peritonitis. In life, especially married women, they must pay attention to their personal hygiene and try not to eat spicy and irritating foods to avoid pelvic peritonitis. If you unfortunately suffer from pelvic peritonitis, you must understand its diagnosis method. Next, the editor will introduce to you what are the diagnostic criteria for pelvic peritonitis?

1. Minimum diagnostic criteria:

(1) Uterine tenderness

(2) Adnexal tenderness

(3) Cervical pain

The possibility of PID diagnosis is greatly increased in patients with lower abdominal tenderness accompanied by signs of lower genital tract infection.

2. Additional diagnostic criteria:

Body temperature exceeds 38.3℃; there is mucopurulent discharge from the cervix or vagina; a large number of white blood cells are seen in 0.9% NaCl smear of vaginal discharge; the erythrocyte sedimentation rate is increased; the blood C-reactive protein is increased; laboratory confirmation of cervical gonorrhea Neisseria or Chlamydia trachomatis is positive.

3. Specific diagnostic criteria:

Endometrial biopsy revealed histological evidence of endometritis; transvaginal ultrasonography or magnetic resonance imaging showed tubal wall thickening, luminal fluid, with or without pelvic effusion, or tubo-ovarian abscess; and laparoscopy showed abnormal findings consistent with PID.

For patients with a history of acute pelvic peritonitis and symptoms and signs, the diagnosis is usually not difficult. However, sometimes patients have more symptoms but no obvious history of pelvic peritonitis and positive signs. At this time, the diagnosis of chronic pelvic peritonitis must be cautious to avoid making a rash diagnosis and causing mental burden on patients. Sometimes pelvic congestion or varicose veins in the broad ligament can also produce symptoms similar to chronic inflammation. Chronic pelvic peritonitis and endometriosis are sometimes difficult to distinguish. Endometriosis dysmenorrhea is more obvious. If typical nodules can be felt, it will help with diagnosis. Laparoscopy can be performed when the distinction is difficult. Hydrosalpinx or tubo-ovarian cysts need to be differentiated from ovarian cysts. In addition to a history of pelvic peritonitis, the former has a sausage-shaped mass, a thin cyst wall, and adhesions around it; while ovarian cysts are generally more round or oval, with no adhesions around them and free movement. Pelvic peritonitis adnexal masses are adherent to the surrounding area and are immobile, which can sometimes be confused with ovarian cancer. Inflammatory masses are cystic while ovarian cancer is solid. B-mode ultrasound examination can help to differentiate them.

Acute and chronic pelvic peritonitis can be diagnosed based on medical history, symptoms and signs. However, differential diagnosis must be done well. The main differential diagnosis of acute pelvic peritonitis includes: acute appendicitis, ectopic pregnancy, ovarian cyst pedicle torsion, etc.; the main differential diagnosis of chronic pelvic peritonitis includes: endometriosis and ovarian cancer.