Uterine tenderness

Introduction Pelvic inflammatory disease Abdominal examination of the lower abdomen has tenderness, rebound tenderness and muscle tension, pelvic examination of cervical congestion, edema, obvious pain, uterine tenderness. Mainly caused by the disease caused by acute endometritis and acute uterine myositis, acute salpingitis, fallopian tube empyema, fallopian tube ovarian abscess, acute pelvic connective tissue inflammation, acute pelvic peritonitis. Pelvic inflammatory disease has not been completely treated, or the patient's constitution is poor, and the course of disease is delayed. It can cause chronic salpingitis and hydrosalpinx, tubal oophoritis and chronic pelvic connective tissue inflammation.

Cause

The main pathogens causing pelvic inflammatory disease are: staphylococcus, Escherichia coli, anaerobic bacteria, sexually transmitted pathogens (such as gonococcus, Chlamydia trachomatis, Mycoplasma, herpes virus). The main cause of acute pelvic inflammatory disease is postpartum or abortion infection, infection after intrauterine surgery, poor menstrual period, and direct inflammation of adjacent organs.

an examination

Related inspection

Gynecological ultrasound examination of postpartum pelvic floor muscles and evaluation of fertility vaginal discharge examination HCG semi-quantitative

Clinical manifestations:

The symptoms of acute pelvic inflammatory disease are: acute illness, serious illness, lower abdominal pain, fever, chills, headache, loss of appetite. During the examination, the patient was found to have acute illness, high body temperature, fast heart rate, muscle tension, tenderness and rebound tenderness in the lower abdomen. Pelvic examination: There is a large amount of purulent secretion in the vagina, and there is obvious tenderness in the sputum. The uterus and the double attachments have tenderness, rebound tenderness, or thickening of one side attachment. The symptoms of chronic pelvic inflammatory disease are characterized by slow disease and long course of disease. The systemic symptoms are not obvious, but may have low fever, fatigue, and low back pain. During the examination, it was found that the uterus often showed a posterior position, limited mobility, or adhesion fixation.

1. Symptoms:

(1) The systemic symptoms are not obvious, sometimes there may be low fever and fatigue. In patients with longer course of disease, some patients may have symptoms of neurasthenia, such as lack of energy, general discomfort, and insomnia. When patients have poor resistance, they are prone to acute or subacute attacks.

(2) Scar adhesion and pelvic congestion caused by chronic inflammation can cause lower abdomen bulge, pain and lumbosacral pain. Often exacerbated after exertion, after sexual intercourse and before and after menstruation. (3) due to pelvic bleeding, patients may have increased menstruation; ovarian dysfunction may have menstrual disorders; tubal adhesions can cause infertility.

2. Signs: The uterus is often in the posterior position, with limited mobility or adhesion. In the case of salpingitis, the thickened fallopian tube is touched on one or both sides of the uterus, which is cord-like and has mild tenderness. If it is hydrosalpinx or fallopian tube ovarian cyst, cystic mass is felt on one side or both sides of the pelvis, and the activity is limited. In the case of pelvic connective tissue inflammation, there is flaky thickening and tenderness on one or both sides of the uterus, and the uterine ligament is thickened, hardened, and tender.

Differential diagnosis

There is a pain in the cervix: the pain in the cervix is one of the typical signs of ectopic pregnancy, that is, the cervix is tender.

Aura uterus rupture: uterine rupture of the uterus in the process of labor, when the fetal first exposed part of the decline is blocked, the strong constriction makes the lower uterus gradually thinner and the palace is thicker and shorter, forming a distinct annular depression between the two The depression will gradually rise above the umbilical or umbilicus, called the pathologic retraction ring. Maternal self-reported lower abdomen pain, irritability, shortness of breath, difficulty urinating, pulse increased.

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