Peritonitis _ general knowledge of pelvis

Peritonitis _ general knowledge of pelvis
[Sum up ] Women's pelvis genitals inflammation, often pelvis peritonitis (pelvic peritonitis) with various intensity . Whole the intersection of pelvis and peritoneum take place inflammatory change, even but from disperse to the whole belly a few case, become filling the air peritonitis. Because of pelvis peritonitis or abdominal cavity's other internal organs inflammation pathological changes sometimes, the liquid of suppuration is gathered on the lowest position of the abdominal cavity - -The uterus rectum nest, and form uterus rectum nest abscess. [Diagnose ] According to medical history, symptom and physical sign, easy to make diagnosis, but should notice that punch to distinguish with acute appendicitis. In addition, some diseases have symptom of similar acute pelvis peritonitis, such as attachment tumour base of a fruit turning back, oviducal hematoma breaking, uterus skin tumour and necrosis, etc., special abdominal cavity's massive haemorrhage (if oviducal gestation breaks) Peritoneum that cause stimulate symptom, sometimes true and pelvis peritonitis, person who fill the air some physical sign of peritonitis very much difficult to distinguish, and it cause paining and tenderness of right upper abdomen that a few pelvis peritonitis is expanded to the gallbladder, the physical sign of the easy cholecystitis is obscured again. Should ask the medical history in details while meeting such situations, consult other situations of whole body (such as body temperature, blood pressure and general situation) Could obtain and diagnose. Chronic pelvis peritonitis have concurrently more chronic oviduct ovarian inflammation, chronic uterus myositis and pathological changes, so often there are all symptoms of chronic pelvis genitals inflammation. It is all the same to treat the principle, there is no necessity distinguished one by one. [Treat the measure ] The same as ovarian inflammation treatment of acute oviduct, because pelvis peritonitis has oneselfs that protects the function, should walk surgery while being excessive, cause, destroy and make inflammation spread instead, so treatment principle completely different from filling the air peritonitis. Should adopt and support treatment and control to infected etc. and does not perform the operation the treatment all over. But if there is abscess to take shape, should cut and guide through the belly or by the vagina. [The cause of disease is studied ] When the first, acutth oviducal inflammation sows scattered oviduct acute inflammation, are in charge of liquid of suppuration overflows through the belly accent, or inflammation around of the oviduct spreads and brings about inflammation pathological change in peritoneum of pelvis directly. Second, continue the hair and organize inflammation in the pelvis honeycomb. Third, other surgical illness such as appendicitis, diverticulum inflammation punches. [Pathology changes ] The peritoneum of whole pelvis is congested, a large number of slurries ooze out the liquid and include the fibrin. After turning into chronically, the uterus, attachment and intestines glue and link the group, large omentum picture roof kind and other internal organs adhesions from the pelvis entry extensively, form the first parcel inflammation lump. This kind of adhesion, have the certain one since the body protects function, confine inflammation to the pelvis, avoid it to the whole belly disperse. The absorbability of the peritoneum of pelvis is lower than the upper abdomen, and can limit the absorption of the toxin, but the adhesion interval oozes out the liquid to exist, and there is occuring frequently small abscess to leave over sometimes, some can totally absorb, there can not be traces besides close adhesion. [Clinical manifestation ] Because acute pelvis peritonitis seldom takes place originally, so there is medical history of acute pelvis organ inflammation more before having illness coming on. Patient's hyperpyrexia, shiver with cold, the body temperature can reach or more 40 . One kind of lower abdomens of violent convulsion pains, it is the continuation, disgusting and vomiting, aggravate at the time of the activity; Urinate, stool hour pain, diarrhoea or constipation occasionally. The patient likes to fetch two legs to flex horizontally, in order to lighten the tense pain of belly wall. The serious one, can have the fidgets, whole body is depleted, even clouded in mind, delirium, going into a coma,etc.. Physical sign: Belly wall better and frank nervous, tabular belly, serious tenderness and jumping and aching instead, the patient refuses to press, the following belly is very particularly. Therefore it is impossible for the gynaecology to check several, even it is also unsatisfied to check. The whole palace necks, domes touch a tender spot obviously. At this stage, doctors should not impose and do pair and examine the inspection jointly. It is ashen that the serious patient can present shock, blood pressure and dropping, complexion, something shaped like a tongue is done, the cold sweat appears etc., collapsing, lung edema in heart failure,etc. happens later. Can be obtained and diagnosed according to the above-mentioned clinical symptom. Leucocyte, neutral leucocyte number increase, the obvious acceleration rate of erythrocyte sedimentation rate. Chronic one can touch genitals and big omentum, intestines glueing into the surface to be not smooth, bag piece not of uniform size, tenderness, fixing.
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