What tests are done for pelvic peritonitis

Tenderness and rebound tenderness are the main signs of pelvic peritonitis and are always present. The degree of abdominal muscle tension varies with the cause and the patient's general condition. Abdominal percussion may produce tympanic sounds due to gastrointestinal bloating. When there is a lot of fluid in the abdominal cavity, mobile dullness can be percussed, which can also be used to locate necessary abdominal puncture. Auscultation often finds that bowel sounds are weakened or disappeared. Next, I will introduce the examinations that need to be done for this disease.

1. Laboratory tests and X-ray examinations

The white blood cell count is increased, but when the condition is serious or the body's response is low, the white blood cell count is not high, only the proportion of neutrophils is increased or toxic particles appear. Abdominal X-ray examination can show signs of intestinal paralysis such as widespread distension of the intestinal cavity and multiple small gas and liquid levels. In the case of gastrointestinal perforation, free gas can be seen under the diaphragm in most cases (the fluoroscopy should be performed in a standing position). This is of great significance in diagnosis. For patients with weak constitutions or patients who cannot stand for fluoroscopy due to shock, side-lying radiographs can also be taken to show whether there is free gas.

2. Blood test

The total number of white blood cells increased significantly, the number of neutrophils increased, and there was a phenomenon of nuclear left shift. Abdominal puncture examination showed that the protein was more than 4%, the color was turbid, the specific gravity increased (more than 1.018), and the white blood cells could reach more than 20,000/cubic millimeter. Smear examination showed the presence of bacteria.

If further auxiliary examinations are needed for diagnosis, such as rectal examination, pelvic examination, diagnostic abdominal and female posterior fornix puncture in low semi-recumbent position, the cause can be determined based on the color, smell, and properties of the fluid obtained by puncture, smear microscopy, or quantitative determination of amylase value.