Parametritis

Description:

Parametritis — an inflammation of perimetric cellulose. Arises most often after various interventions on a uterus (pathological childbirth, abortions, gynecologic operations). Pathogenic or opportunistic flora gets into a parametrium at traumatization of a uterus or — is more rare — a lymphogenous or hematogenous way from a number of the located infection centers (an adnexitis, an endocervicitis, a colpitis).

Parametritis symptoms:

One of the first symptoms of a disease is permanent temperature increase (at suppuration it can gain intermittent character). Originally general condition of the patient is almost not changed, then symptoms of intoxication — a headache, weakness, slackness, an adynamia appear and accrue. There are complaints to dull ache in a stomach bottom, pressure sense on a rectum, the dysuric phenomena and difficulties of the act of defecation can join.
In blood of patients only permanent increase in SOE is usually noted. At development of suppuration of infiltrate arise a leukocytosis with neutrophylic shift to the left, a disproteinemia and so forth. At a bimanual research shortening and smoothing back or side vaults of the vagina, more expressed from defeat (or evenly — is defined at total infiltrate). The uterus completely does not konturirutsya as it is included in inflammatory infiltrate partially or entirely. Then sideways from a uterus infiltrate, at first softish, later — a dense consistence is defined.

Signs of irritation of a peritoneum are absent. The stomach palpation at the beginning of a disease is painless or the maloboleznenna, when developing suppuration a stomach to become sensitive at a palpation. Complications can arise at untimely diagnosis and development of suppuration of infiltrate — break of an abscess in a free abdominal cavity, a rectum, a bladder.

Parametritis reasons:

After implementation of an infection in parametriums diffusion inflammatory infiltrate which is capable to suppurate (at the modern level of therapy it occurs rather seldom) is formed, to resolve or get a chronic current. Infiltrate usually is located in certain areas: from front department of a neck of lateral edges of a bladder to a front abdominal wall, from perednebokovy departments of a neck — to a pupartovy ligament and side departments of a stomach, from posterolateral departments of a neck — to basin walls, from back department of a neck — to a rectum.

Treatment of the Parametritis:

It is necessary to begin treatment with prescription of antibiotics of a wide range or drugs of a ftorkhinolonovy row (ciprofloxacin) in combination with metronidazole within 5 — 7 days. The woman is on a high bed rest, cold on a stomach bottom, intravenous drop administration of Calcium chloratum to 150 ml of 3% solution is shown. At suppuration open an abscess through a back vault of the vagina or from a front abdominal wall (vnebryushinno). At synchronization of process it is possible to use Prednisolonum in a daily dose of 20 mg within 10 days with the subsequent transition to NPVS, at normalization of indicators of blood are shown ultrasound on a stomach bottom, easy heat, candles with indometacin. The disease differs in long involution.

4 — 6 months later sanatorium treatment with use of mud vulval pads, hydrosulphuric irrigations or trays, gynecologic massage is shown.