Treatment of chronic pelvic peritonitis

Pelvic peritonitis is a common and serious surgical disease caused by bacterial infection, chemical stimulation or injury. Its main clinical manifestations are abdominal pain, abdominal muscle tension, nausea, vomiting, fever, and in severe cases, it can cause a drop in blood pressure and systemic toxic reactions. Generally, this disease needs to be treated with the following methods.

1. Body position

When there is no shock, the patient should take a semi-recumbent position, which is conducive to the accumulation of exudate in the abdomen in the pelvic cavity, because the symptoms of pelvic abscess poisoning are mild and it is also convenient for drainage. In the semi-recumbent position, the lower limbs should be moved frequently to change the pressure points to prevent venous thrombosis and bedsores.

2. Fasting

Patients with gastrointestinal perforation must absolutely fast to reduce the continued leakage of gastrointestinal contents. For patients with pelvic peritonitis caused by other causes who have already developed intestinal paralysis, eating can aggravate the accumulation of fluid and gas in the intestines and worsen abdominal distension. Eating can only be started after the intestinal peristalsis returns to normal.

3. Gastrointestinal decompression

It can reduce gastrointestinal distension, improve gastrointestinal wall blood circulation, and reduce the leakage of gastrointestinal contents into the abdominal cavity through the rupture. It is an indispensable treatment for patients with pelvic peritonitis. However, long-term gastrointestinal decompression hinders breathing and coughing, and increases fluid loss, which can cause hypochloremic and hypokalemic alkalosis. Therefore, once intestinal peristalsis returns to normal, the gastric tube should be removed as soon as possible.

4. Analgesia

It is necessary to use sedatives and analgesics appropriately to relieve the patient's pain. For patients whose diagnosis has been confirmed and whose treatment has been decided, it is also permissible to use pethidine or morphine to stop severe pain, and it has a certain effect in strengthening the tension of the intestinal wall muscles and preventing intestinal paralysis. However, if the diagnosis has not yet been confirmed and the patient still needs to be observed, it is not appropriate to use analgesics to avoid masking the condition.