Diagnostic approach to acute pelvic peritonitis

Acute pelvic peritonitis is a gynecological disease with many complications. It can be acute or chronic. Acute pelvic peritonitis is seriously life-threatening and can cause diffuse peritonitis, sepsis, and septic shock. Female friends must pay attention to it. In order to effectively prevent acute pelvic peritonitis, we must first know how to diagnose acute pelvic peritonitis.

1. Pathogen culture

The specimens are from the same source as above. They should be inoculated on Thayer-Martin medium immediately or within 30 seconds and cultured in a 35°C incubator for 48 hours to identify bacteria by glycolysis. The new relatively rapid chlamydial enzyme assay has replaced the traditional chlamydia detection method. Chlamydia trachomatis antigen detection can also be performed using mammalian cell culture. This method is an enzyme-linked immunosorbent assay. The average sensitivity is 85.9% and the specificity is 98.4%. Bacteriological culture can also obtain other aerobic and anaerobic strains and serve as a basis for selecting antibiotics.

2. Direct smear of secretions

The samples can be vaginal, cervical secretions, or urethral secretions, or peritoneal fluid (obtained through the posterior fornix, abdominal wall, or through laparoscopy), and direct thin-layer smears are made, which are then dried and stained with methylene blue or Gram. Anyone who sees Gram-negative diplococci in polymorphonuclear leukocytes is infected with gonorrhea. Because the detection rate of cervical gonorrhea is only 67%, a negative smear cannot rule out the presence of gonorrhea, and a positive smear is very specific. Fluorescein monoclonal antibody dye can be used for microscopic examination of Chlamydia trachomatis. Any star-shaped flashing fluorescent dots observed under a fluorescence microscope are positive.

3. Ultrasound examination

Mainly B-mode or grayscale ultrasound scanning and filming, this technology has an 85% accuracy in identifying masses or abscesses formed by adhesions of the fallopian tubes, ovaries and intestines. However, mild or moderate pelvic peritonitis is difficult to show characteristics in B-mode ultrasound images.