Surgical treatment of patients with acute pelvic inflammatory disease

If acute pelvic inflammatory disease is not treated promptly, it may develop into chronic pelvic inflammatory disease. Patients with acute pelvic inflammatory disease should undergo surgical treatment if drug treatment is ineffective, abscess ruptures, fallopian tube pyosalpinx or fallopian tube-ovarian abscess occurs.

Indications for surgery in patients with acute pelvic inflammatory disease

Ineffective drug treatment: If the body temperature of patients with acute pelvic inflammatory disease continues to rise after 48 to 72 hours of drug treatment, or if the patient's poisoning symptoms worsen or the mass increases, surgery should be performed promptly to avoid abscess rupture.

Pyroses in the fallopian tube or tubo-ovarian abscess: The patient's condition improves after drug treatment. After continuing to control the inflammation for several days, if the lump still does not disappear but has become localized, surgical removal should be performed to avoid another acute attack in the future that still requires surgery.

Abscess rupture: If the patient suddenly has worsening abdominal pain, chills, high fever, nausea, vomiting, abdominal distension, and obvious abdominal tenderness or signs of toxic shock during examination, it should be suspected that the abscess has ruptured and an immediate laparotomy is required.

Surgical treatment of patients with acute pelvic inflammatory disease

Surgery can be performed through the abdomen or laparoscopy according to the patient's condition. The scope of surgery should be based on the extent of the lesion, the patient's age, general condition, etc., with the main focus being on removing the lesion.

Young women should try their best to preserve ovarian function, with conservative surgery as the main approach; for older women, those with bilateral adnexal involvement or repeated adnexal abscesses, total hysterectomy and bilateral salpingo-oophorectomy should be performed; the scope of surgery for extremely debilitated and critically ill patients must be determined based on specific circumstances.