What are the pathological factors of acute pelvic inflammatory disease?

Every woman should pay attention to reproductive health issues, because if we don’t pay attention to these care and health care, it will be easy for some gynecological diseases to take advantage, such as pelvic inflammatory disease, which is a disease that many women will face nowadays. Let us learn about some pathological introductions of acute pelvic inflammatory disease. I hope that every female friend can be vigilant and take precautions to ensure health.

1. Pathology

Experts point out that the pathogen can spread upward along the genital tract mucosa, can be directly infected by inflammation of adjacent organs, spread through the lymphatic system, or be transmitted through the blood circulation. Inflammation can be confined to one site or occur in several sites simultaneously, with different pathological manifestations in different sites.

Pathogens invading the uterus can cause acute endometritis or myometritis; inflammation spreading to the fallopian tubes and ovaries can cause acute salpingitis or acute salpingo-oophoritis, also known as acute adnexitis; involvement of the fallopian tube mucosa can cause adhesion of the lumen or closure of the fimbria, forming a fallopian tube abscess; if the fallopian tube penetrates the ovary, a fallopian tube-ovarian abscess will form.

If the inflammation spreads to the pelvic connective tissue through the lymph nodes, it can cause acute pelvic connective tissue inflammation. If the inflammation spreads to the pelvic peritoneum, it can cause acute peritonitis. If there is exudation, it will accumulate in the rectouterine pouch, forming pelvic abscess. When the body's resistance is low and the pathogens are highly toxic and numerous, sepsis, septicemia, septic shock and even death may occur.

2. Clinical manifestations

The clinical manifestations of acute pelvic inflammatory disease may vary depending on the severity and extent of the inflammation. Common symptoms include lower abdominal pain accompanied by fever. In severe cases, there may be high fever, chills, headache, increased vaginal discharge, purulent discharge, and a foul odor. If peritonitis occurs, nausea, vomiting, and abdominal distension may occur. If an abscess is formed, there may be a mass in the lower abdomen and local compression and irritation symptoms. If the mass is located in front of the uterus, bladder irritation symptoms such as frequent urination, difficulty urinating, and painful urination may occur; if the mass is located behind the uterus, there may be rectal irritation symptoms; if it is extraperitoneal, it may cause diarrhea, tenesmus, and difficulty defecation.

During the examination, the patient was found to be in acute pain, with elevated temperature, tense lower abdominal muscles, tenderness and rebound pain.

Gynecological examination shows congestion of the vagina and cervix, with purulent secretions or pus flowing out of the cervical opening; when there is pus in the rectouterine pouch, the posterior fornix is ​​full, the cervix is ​​painful when raised, and there is a sense of fluctuation; in case of endometrium or myometritis, the uterus is slightly enlarged and tender; in case of simple salpingitis, a thickened fallopian tube can be touched with tenderness; in case of pyosalpinx or tubo-ovarian abscess, a mass can be touched with obvious tenderness; in case of parametrial connective tissue inflammation, flake-like thickening can be touched on one or both sides of the parametrium with tenderness; if a pelvic abscess is formed and is located lower, a mass can be felt in the posterior fornix or lateral fornix with a sense of fluctuation; in case of pelvic peritonitis or diffuse peritonitis, the patient's abdominal muscles are tense, with tenderness and rebound pain.

The occurrence of many gynecological diseases is closely related to some bad living habits in our lives. For example, if a person does not pay attention to reproductive health and hygiene, and has unhealthy sexual behaviors for a long time, these gynecological diseases may occur and threaten our reproductive health.