Can pelvic inflammatory disease be detected by ultrasound?

Pelvic inflammatory disease is a common gynecological disease. When this disease is suspected, you need to go to the hospital for examination in time. B-ultrasound is a common examination method. It can be confirmed by B-ultrasound examination. In addition to B-ultrasound examination, there are also smear examinations of secretions, culture examinations of pathogens, laparoscopy, etc. Only through multiple examination methods can the cause of the disease be determined and then regular treatment can be carried out.

1. Direct smear examination of secretions

The samples can be vaginal, cervical, or urethral secretions, or peritoneal fluid (obtained through the posterior fornix, abdominal wall, or laparoscopy), and direct thin-layer smears are made and stained with methylene blue or Gram's blue after drying. If Gram-negative diplococci are seen in polymorphonuclear leukocytes, it is a gonorrhea infection. Because the detection rate of endocervical gonorrhea is only 67%, a negative smear cannot exclude the presence of gonorrhea, while a positive smear is very specific. Fluorescein monoclonal antibody dye can be used for microscopic examination of Chlamydia trachomatis. The test is positive if a star-shaped flashing fluorescent spot is observed under a fluorescence microscope.

2. Pathogen culture test

The specimens come from the same source as above and should be inoculated onto Thayer-Martin medium immediately or within 30 seconds and cultured in a 35°C incubator for 48 hours for bacterial identification based on glycolysis. New relatively rapid chlamydial enzyme assays have replaced traditional chlamydial detection methods and can also be performed using mammalian cell culture.

3. Posterior fornix puncture examination

Posterior fornix puncture is one of the most commonly used and valuable diagnostic methods for gynecological acute abdomen. The contents of the abdominal cavity or the rectouterine fossa obtained through puncture, such as normal peritoneal fluid, blood (fresh, old, clotted blood, etc.), purulent secretions or pus, can further clarify the diagnosis. Microscopic examination and culture of the punctured material are even more necessary.

4. Ultrasound examination

It mainly uses B-type or grayscale ultrasound scanning and filming. This technology has an 85% accuracy in identifying masses or abscesses formed by adhesions of the fallopian tubes, ovaries and intestines. However, mild or moderate pelvic inflammatory disease is difficult to show characteristics on B-mode ultrasound images.

5. Laparoscopy

If it is not diffuse peritonitis and the patient's general condition is good, laparoscopy can be performed on patients with pelvic inflammatory disease or suspected pelvic inflammatory disease and other acute abdominal diseases. Laparoscopy can not only make a clear diagnosis and differential diagnosis, but also make a preliminary judgment on the severity of pelvic inflammatory disease.