How to examine acute pelvic peritonitis

Don't be careless if you have pelvic peritonitis. For your own health, you must adhere to the principle of early detection and early treatment. Before receiving treatment, you must also do a careful examination to help cure the disease. So what are the symptoms of pelvic peritonitis? How to check it? Let's listen to the experts' explanation below!

What are the symptoms of pelvic peritonitis?

Since acute pelvic peritonitis is rarely primary, there is often a history of acute pelvic organ inflammation before the onset of the disease.

The patient has a high fever and chills, with a body temperature of 40°C or above. There is severe cramp-like lower abdominal pain, which is persistent, often accompanied by nausea and vomiting, which is aggravated by activity; there is pain during urination and defecation, and sometimes diarrhea or constipation. The patient likes to lie with his legs bent to relieve the tension and pain of the abdominal wall. In severe cases, irritability, systemic exhaustion, and even confusion, delirium, and coma may occur.

Signs: Tension of abdominal wall, rigidity, board-like abdomen, severe tenderness and rebound pain, the patient refuses to press, especially in the lower abdomen. Therefore, gynecological examination is almost impossible, and even if it is examined, it is unsatisfactory. The entire cervix and fornix are obviously tender. At this stage, the doctor should not force a bimanual examination. Severe patients may experience shock, decreased blood pressure, grayish complexion, dry tongue, cold sweat, etc., and later collapse, heart failure, pulmonary edema, etc. can occur. The diagnosis can be made based on the above clinical symptoms. The number of white blood cells and neutrophils is increased, and the erythrocyte sedimentation rate is significantly increased.

In the chronic stage, the reproductive organs, greater omentum, and intestines may be attached to form uneven masses of varying sizes, which are tender and fixed.

How to examine pelvic peritonitis?

Physical examination: acute appearance, fever, obvious tenderness, rebound pain, or board-like abdomen. Gynecological examination shows congestion of the vaginal mucosa, purulent secretions at the cervix, and obvious tenderness in the fornix during bimanual examination. If there is a uterine rectal fossa abscess, the posterior fornix will be more tender, or a sense of fullness and fluctuation can be felt. Anal examination can feel fluctuations and bulges on the anterior wall of the rectum.

Imaging diagnosis: Ultrasound examination: When an abscess is formed, a tumor can be detected by B-type ultrasound examination. Its outline is often irregular, with dense echoes around it and an echo-free area inside.

Laboratory diagnosis: Abdominal puncture and posterior fornix puncture can extract fluid, which is mostly light yellow, thin bloody fluid, yellow exudate or pus. It can be sent to the laboratory for examination or bacterial culture.

The number of peripheral blood white blood cells and neutrophils increases, the erythrocyte sedimentation rate accelerates, and pathogenic bacteria can be cultured from cervical secretions or blood.

The above information is the symptoms and examination items of pelvic peritonitis introduced to you by relevant experts. I believe it can bring certain help to everyone. For patients, if you want to make the condition better faster, you must attach importance to treatment and listen more to the doctor's advice. During the treatment, you must change bad living habits and pay attention to personal cleanliness and hygiene, so that the condition can get better faster.