Diseases that should be differentiated from chronic pelvic inflammatory disease

Chronic pelvic inflammatory disease is often caused by incomplete treatment of acute pelvic inflammatory disease, which leads to a prolonged course of the disease in patients with poor physical condition. However, there may be no history of acute pelvic inflammatory disease, such as salpingitis caused by Chlamydia trachomatis infection. Diseases that should be differentiated from chronic pelvic inflammatory disease include endometriosis, tuberculous pelvic inflammatory disease, ovarian cancer, and old ectopic pregnancy.

1. Endometriosis: The dysmenorrhea of ​​endometriosis is secondary and progressive. If typical tender nodules can be felt, it will help with diagnosis.

2. Ovarian cancer: Adnexal inflammatory masses are adhered to the surrounding areas and are immobile, which can sometimes be easily confused with ovarian cancer. Chronic inflammatory masses are mostly cystic; while ovarian cancer masses are mostly solid, hard, and have irregular surfaces. Hard nodules can be felt in the rectouterine fossa, and there is often ascites. The patient's general condition is poor, and B-type ultrasound examination is helpful for differentiation.

3. Old ectopic pregnancy: Most cases have a history of amenorrhea and vaginal bleeding, lower abdominal pain on the affected side, and gynecological examination shows an adhesion mass next to the uterus, which is tender to the touch. Laparoscopic examination is helpful for diagnosis.

4. Tuberculous pelvic inflammatory disease: It is also a chronic disease, and there is often a history of tuberculosis in other organs. The abdominal pain is often persistent, and there is occasionally a history of amenorrhea. There is often endometrial tuberculosis, abdominal distension, and occasionally abdominal masses. X-ray examination of the lower abdomen shows calcification foci, and the mass is located higher than that of chronic pelvic inflammatory disease. Laparoscopic examination and biopsy can confirm the diagnosis. Sometimes pelvic congestion or varicose veins in the broad ligament can also produce symptoms similar to chronic pelvic inflammatory disease, and they should also be distinguished.