How to Differentially Diagnose Acute Pelvic Peritonitis

Female pelvic reproductive organ inflammation is often accompanied by various degrees of pelvic peritonitis. In severe cases, the entire pelvic peritoneum undergoes inflammation and changes. Pelvic peritonitis is very harmful to female friends. Experts say that if you want to accurately diagnose pelvic peritonitis, you can look at its identification and diagnosis clinically.

1. Clinical manifestations

Acute pelvic peritonitis is often secondary to acute adnexitis, so its clinical manifestations often further worsen on the basis of the primary disease.

1. Symptoms:

The high fever persists and can reach up to 40℃, the pulse speeds up, the lower abdominal pain intensifies and becomes persistent, and is often accompanied by vomiting. The patient is forced to lie down with the lower limbs flexed to relieve the pain. Under the influence of toxins, there is often abdominal distension and diarrhea, mostly watery stools. If it is Staphylococcus aureus infection, the stool is often egg-drop-shaped. In severe cases, patients are irritable, pale, sweating, and their lips and fingernails (toenails) are slightly swollen. This is a precursor to septic shock. If it is not discovered in time, the opportunity for rescue is often lost.

2. Physical signs: Tension of abdominal muscles, obvious tenderness and rebound pain, especially in the lower abdomen, and the patient refuses to press. If paralytic ileus occurs, there may be signs such as intestinal flatulence, abdominal distension, weakened intestinal motility, and disappearance of bowel sounds. Bimanual examination: Cervical lifting pain, obvious tenderness in the uterus and fornix. Due to tension of abdominal muscles and refusal to press, it is difficult to touch the mass during examination.

2. Diagnosis and differential diagnosis

According to the medical history and clinical manifestations, the diagnosis is not difficult. However, pelvic peritonitis is mostly secondary, and the treatment principles vary greatly due to the different primary diseases. Therefore, it is important to distinguish whether it is the spread of secondary infections such as ovarian tumor torsion, tubal pregnancy hematoma, uterine fibroid necrosis, or the spread of acute pelvic infection, so as to facilitate timely and accurate treatment.