Pelvic sagging

Introduction The pelvic sag is the clinical manifestation of pseudomyxoma peritonei (PMP). It is a low-grade mucinous mucosa that occurs in the peritoneal wall, the greater omentum, and the serosal surface of the intestinal wall. Abdominal pain is the main complaint, there are repeated episodes of lower right abdomen pain or discomfort or pelvic sag, right lower abdomen mass or intestinal obstruction, peritonitis and other complications, the rate of misdiagnosis is as high as 89.7%, the examination may have ascites and borders Clear nodules are often misdiagnosed as cirrhosis and tuberculous peritonitis, abdominal cysts, etc. and delay treatment.

Cause

The etiology of peritoneal pseudomyxoma is still unclear. Because this disease is an ovarian mucinous cyst, ovarian mucinous cystadenoma or appendix mucus cyst is broken. When the mucus is discharged, it often contains epithelial cells and enters the abdominal cavity together. In terms of mucus and epithelial cells, the peritoneum stimulates the peritoneum, causing an inflammatory reaction. On the other hand, it continues to secrete mucus to accumulate a large amount of gelatinous mucus in the abdominal cavity, causing colloidal ascites, called "adhesive belly", and possibly through blood flow and lymph. According to the metastatic spread of the tube, about 45% of the tumor cells are derived from the ovary, 29% are from the appendix, 26% are indeterminate, and 1% to 2% of the ovarian tumors can develop into a peritoneal pseudomyxoma.

an examination

Related inspection

Pelvic and vaginal B-ultrasound routine examination

Signs:

(1) abdominal distension: is the main sign of the disease, the following abdominal swelling is more common, such as total abdominal peritoneal involvement, may have a full abdominal high bulging, or even a full-term pregnancy.

(2) tenderness and mass: the patient's abdomen is soft, a few are tender, but not significant; most patients may have a bump in the abdomen, especially in the right lower abdomen or lower abdomen, but the whole abdomen can be licked; the size of the mass Different, ranging from a few centimeters to tens of centimeters, the texture is harder; the surface is uneven, and the activity is small.

(3) Liver enlargement: Most patients have enlarged liver and are tough or slightly hard.

(4) Ascites sign is positive, due to different ascites viscosity, the patient may show abdominal fluctuations or behave as mobile dullness.

(5) normal bowel sounds or hyperthyroidism: abdominal auscultation of bowel sounds is basically normal, intestinal obstruction may have enhanced and gas over water.

(6) Others: Due to the early and late course of the disease and the degree of tumor invasion, the digital rectal examination may have varying degrees of fullness, rectal stenosis or touching the extra-intestinal mass. Gynecological examination often reveals uterine attachment or uterine rectal recess. Tumor.

In recent years, the disease can be diagnosed by abdominal wear, B-ultrasound, CT, laparoscopy, and mass biopsy.

Medical history:

Some patients have appendix and a history of ovarian surgery.

Clinical features:

The general condition of the physical examination is still good, the abdomen is bulging, and the uneven mass can be touched. This is a prominent feature of the disease.

Laboratory and auxiliary inspection:

Diagnostic abdominal puncture only draws a small amount of viscous liquid; B-ultrasound and CT show multiple masses and ascites in the abdomen.

Differential diagnosis

To be differentiated from the pelvic weight. It also causes pelvic pain. At the same time, the main symptom of pelvic weight is increased vaginal discharge.

In addition, it must be differentiated from the lower abdomen bulge. Lower abdominal bulge is mainly related to pelvic congestion, and many of them can be classified as medically known as pelvic congestion syndrome.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.