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Chronic Pelvic Inflammatory Disease


Presentation

  • Abstract A case of massive exudative hemorrhagic ascites occurring as a serious complication of chronic pelvic inflammatory disease (PID) is presented.[ncbi.nlm.nih.gov]
  • Mean difference (MD), standard mean difference (SMD), and dichotomous data will be used to present continuous outcomes.[ncbi.nlm.nih.gov]
  • And early presentation for the diagnosis and treatment of pelvic pain should be a key message of all sexual health promotion programs.[theconversation.com]
  • For example, the bacteria that are normally present in a healthy vagina can multiply and cause an infection. The exact cause of this is not completely known.[ic.steadyhealth.com]
  • Case Presentation A 44 year old para 2012 presented to a local emergency room with a three day history of progressive lower abdominal pain and nausea.[austinpublishinggroup.com]
Ascitic Fluid
  • Other associated findings include 7 : soft tissue stranding and infiltration of pelvic floor fascial planes thickening of uterosacral ligaments Ultrasound Ultrasound often only demonstrates ascitic fluid in the peritoneal cavity or non-specific thickening[radiopaedia.org]
Sighing
  • Support Yang Eliminate Stasis Stop pain Herb Formulas Points Clinical Manifestations Distending pain in the lower abdomen, with guarding May be distending pain in the chest and breasts Epigastric distention Anorexia Restlessness Irascibility Frequent sighing[americandragon.com]
Aspiration
  • The four overarching themes were: (1) the patients' characteristics, including pregnancy aspiration and the fear of serious gynecological disease; (2) the patient-practitioner relationship, including the acupuncturist's attitude towards the patients and[ncbi.nlm.nih.gov]
Abdominal Pain
  • BACKGROUND AND OBJECTIVES: Both irritable bowel syndrome and some gynaecological diseases can give rise to lower abdominal pain, which may result in diagnostic confusion.[ncbi.nlm.nih.gov]
  • […] eyes Dry mouth Anorexia Infertility Abdominal pain Anxiety Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude[americandragon.com]
  • Those symptoms may include fever, foul-smelling vaginal discharge, pain or burning during intercourse or urination, irregular menstrual periods and abdominal pain and cramps.[ic.steadyhealth.com]
  • Both international and national guidelines encourage doctors to treat for PID when a woman presents with lower abdominal pain and all other causes have been excluded.[theconversation.com]
  • Tags: abdominal pain chronic recurrent abdominal pain dysuria Ovarian Torsion sexual transmitted disease Sean M. Fox I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same.[pedemmorsels.com]
Palpitations
  • […] medicinal douches or enemas, medicinal poultices or physical therapy to enhance therapeutic effects Treatment Principle Herb Formulas Points Clinical Manifestations Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations[americandragon.com]
  • The diagnosis for PID is made basing on a physical exam, comprising of abdomen palpitation and internal or pelvic exam, during which the doctor will look for abnormal vaginal discharge, abscesses near or on ovaries or tubes, as well as pain or tenderness[ic.steadyhealth.com]
Blurred Vision
  • vision Heart palpitations Insomnia Dry constipation A sallow complexion T: Pale C: Scanty P: Thready and forceless Treatment Principle Generate Blood Nourish the Nutritive Level Eliminate Stasis Stop pain Herb Formulas Points Clinical Manifestations[americandragon.com]
Dry Eyes
  • eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal[americandragon.com]
Subcutaneous Nodule
  • Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, bleeding, serious discomfort, subcutaneous nodules, and infection.[ncbi.nlm.nih.gov]
Chloasma
  • Chloasma, oral contraceptives, and plasma b-melanocytic-stimulating-hormone. J Inves Dermatol 1977;68:169-70. [ PUBMED ] 7. Sawhney MPS. Chronic actinic dermopathy - A clinical study in Ladakh. Indian J Dermatol Venereol Leprol 2002;68:38-9. 8.[ijdvl.com]
Photosensitivity
  • This study highlights that melasma in women is possibly due to photosensitivity in patients with chronic PID in a majority of cases.[ijdvl.com]
Flushing
  • […] pain Anxiety Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing[americandragon.com]
Epistaxis
  • Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis[americandragon.com]
Suggestibility
  • We suggest that the hyperamylasemia resulted from entry into the circulation of amylase produced within sequestered endosalpingeal epithelial cysts, possibly amplified by impaired renal clearance.[ncbi.nlm.nih.gov]
  • The results of this case study suggest that SWD may be effective in the management of pelvic infections that are unresponsive to chemotherapy.[ncbi.nlm.nih.gov]
  • The authors reported that women with blocked fallopian tubes had lower levels of anti-Mullerian hormone, suggesting a reduced ovarian reserve.[medivizor.com]
  • CONCLUSION: The presence of gastrointestinal symptomatology, especially bowel dysfunction, in a woman with lower abdominal pain is suggestive of irritable bowel syndrome. However, the history may not be so helpful in detecting gynaecological disease.[ncbi.nlm.nih.gov]
  • The majority of cases are considered to arise in pregnancy [2] and in patients on oral contraceptives. [3] The infrequency of melasma in post-menopausal women on oestrogen replacement therapy suggests that it alone is not the causative factor, although[ijdvl.com]
Vertigo
  • […] with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo[americandragon.com]
Pelvic Pain
  • METHODS: A literature search will be conducted electronically with date up to October 2018 in MEDLINE, Cochrane Library, EBASE, and CNKI databases, using combination subject terms of chronic pelvic pain (or chronic pelvic inflammation, and chronic pelvic[ncbi.nlm.nih.gov]
  • pain without any visible pathologic condition (n 4): PGE2 1.11 /- 0.66, PGF2 alpha 0.73 /- 0.55, 6-KF 1.35 /- 0.35, and TxB2 0.39 /- 0.17.[ncbi.nlm.nih.gov]
  • And early presentation for the diagnosis and treatment of pelvic pain should be a key message of all sexual health promotion programs.[theconversation.com]
  • Despite these findings, only 20 (25%) of these patients reported a prior episode of acute pelvic inflammatory disease (PID), and only 18 (22.5%) had complaints of pelvic pain.[ncbi.nlm.nih.gov]
  • Haggerty CL, Schulz R, Ness RB (2003) Lower Quality of Life Among Women With Chronic Pelvic Pain After Pelvic Inflammatory Disease. Obstet Gynecol 102:934–939 Google Scholar 6.[link.springer.com]
Dyspareunia
  • […] unexplained and untreated abdominal pain are significantly more likely to have tubal infertility than women without such history; therefore caution should be used in dismissing mild symptoms (mild non-specific abdominal pain, vaginal discharge, bleeding or dyspareunia[pedsinreview.aappublications.org]
  • The woman usually presents with symptoms of pelvic pain, heavy and painful menstrual periods, pain with intercourse (dyspareunia) and/or infertility that triggers an evaluation that reveals extensive pelvic scar tissue.[haveababy.com]
  • Occasionally, dyspareunia or dysuria occurs. Many women with inflammation that is severe enough to cause scarring have minimal or no symptoms.[merckmanuals.com]
  • More common presentations include acute pelvic pain (of variable intensity), cervical motion tenderness, vaginal discharge, fever, dyspareunia, and leukocytosis. Right upper quadrant pain from perihepatitis in Fitz-Hugh-Curtis syndrome is possible.[radiopaedia.org]
  • Other causes of dyspareunia - eg, endometriosis. Investigations Pregnancy test (pregnant women with PID should be admitted; ectopic pregnancy may be confused with PID).[patient.info]
Adnexal Tenderness
  • The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. Cervical motion, uterine, and lower abdominal tenderness may also be present.[saem.org]
  • Tenderness The following add support for the diagnosis: Fever ( 101 F / 38.3 C) Mucopurulent cervical discharge or friability Wet prep with abundant WBC We always consider: Chlamydia trachomatis Neisseria gonorrhea Rates of these two being the primary[pedemmorsels.com]
  • Sensitivity of clinical diagnosis PID was improved when the patient had adnexal tenderness on exam.) Westrom, L, Joesoef, R, Reynolds, G, Hagdu, A, Thompson, SE. “Pelvic inflammatory disease and fertility.[clinicaladvisor.com]
  • Cervical motion tenderness and adnexal tenderness on bimanual vaginal examination. Fever above 38 C (but may be apyrexial). Other symptoms and signs include nausea or vomiting, urinary symptoms, proctitis and an adnexal mass.[patient.info]
Pelvic Pain in Women
  • Repeated episodes of PID can result in scarring of the Fallopian tubes, which can lead to infertility, ectopic (tubal) pregnancy, or chronic (long-term) pelvic pain. Among women who have had PID, 1 in 8 have difficulties getting pregnant.[my.clevelandclinic.org]
  • Long-term pelvic pain Some women with PID develop long-term (chronic) pain around their pelvis and lower abdomen, which can be difficult to live with and lead to further problems, such as depression and difficulty sleeping (insomnia) .[nhs.uk]
  • This damage can lead to serious health problems such as infertility (unable to have children) or chronic pelvic pain. Some women may even experience ectopic pregnancies (pregnancies outside of the womb).[bphc.org]
Oliguria
  • Herb Formulas Points Clinical Manifestations Pain with guarding in the lower abdomen Often a burning quality May be masses The pain often extends to the low back and sacrum Recurrent low-grade fever Yellow, viscid and malodorous vaginal discharge Dark oliguria[americandragon.com]

Treatment

  • A thermal dosage treatment lasting between 20 and 30 minutes (for each half of the cross-fire technique treatment) was administered. At the beginning of every treatment session, the patient rated her pain perception on a 10-point ratio scale.[ncbi.nlm.nih.gov]
  • Participants reported feeling hope, confidence, and a sense of responsibility for their treatment during the process, although the treatments did not always have the expected outcome.[ncbi.nlm.nih.gov]
  • Systematic reviews and databases will be searched for randomized controlled trials on acupuncture for chronic PID with acupuncture treatment will be included.[ncbi.nlm.nih.gov]
  • Clinical study on oral Chinese medicine combined with enema in the treatment of chronic pelvic inflammation.[degruyter.com]
  • In the early stages the emphasis of treatment is to eliminate the exogenous pathogenic evil. In the later stages the emphasis shifts to restoring or augmenting genuine Qi.[americandragon.com]

Prognosis

  • Prognosis of pelvic inflammatory disease The prognosis of PID depends mostly on the awareness of adolescents to look for timely health care and to prevent future episodes of sexually-transmitted infections.[news-medical.net]
  • What Is the Prognosis? Antibiotic treatment successfully resolves most PID infections.[healthychildren.org]
  • […] become prominent due to infection draining in to lymphatics along the course of the gonadal veins MRI May show an ill-defined adnexal mass containing fluid with various signal intensities: T1 C (Gd): wall and surrounding tissues may enhance Treatment and prognosis[radiopaedia.org]
  • Prognosis and outcome Prognosis and Outcome Approximately 25% of patients diagnosed with acute PID develop long-term sequelae. The risk for sequelae is increased if the patient has recurrent episodes of PID.[clinicaladvisor.com]

Etiology

  • BACKGROUND: Chronic pelvic inflammation disease (PID) is a difficult-to-treat gynecological disorder with complex etiologies. Acupuncture has been applied widely for treating chronic pelvic inflammation or chronic pelvic pain symptoms in China.[ncbi.nlm.nih.gov]
  • Eschenbach DA, Buchanan T, Pollock HM et al. (1975) Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 293:166 Google Scholar 5.[link.springer.com]
  • […] concentration of b-melanocytic-stimulating-hormone in these patients and those on oral contraceptives have been found to be normal. [4], [5] Genetic factors, thyroid dysfunction, cosmetics, phototoxic and antiseizure drugs have been implicated as other etiological[ijdvl.com]
  • The microbial etiology is linked to sexually transmitted microorganisms, including Chlamydia trachomatis, Neisseria gonorrheae, Mycoplasma genitalium, and bacterial vaginosis-associated microorganisms, predominantly anaerobes.[journals.lww.com]
  • PIP: This discussion of acute pelvic inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology and trends in the United States 1975 and 1981. JAMA 251:2529–2533 Google Scholar 13. Westrom L (1980) Incidence, prevalence and trends of acute pelvic inflammatory disease and its consequences in industrialized countries.[link.springer.com]
  • […] inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas, and aerobic and anerobic bacteria); epidemiology[ncbi.nlm.nih.gov]
  • Objectives After completing this article, readers should be able to: Describe the epidemiology and pathogenesis of pelvic inflammatory disease (PID). Recognize the clinical features of PID.[pedsinreview.aappublications.org]
  • Epidemiology The exact prevalence of PID is unknown as it is under-diagnosed and it is also often asymptomatic [ 1 ]. The rate of definite PID diagnosis in primary care is around 280/100,000 person-years [ 2 ].[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • PIP: This discussion of acute pelvic inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas[ncbi.nlm.nih.gov]
  • This review paper in Obstetrics and Gynecology is an excellent up to date source for PID pathophysiology, diagnosis, treatment, and long-term outcomes.) Eschenbach, DA, Wolner-Hanssen, P, Hawes, SE, Pavletic, A, Paavonen, J, Holmes, KK.[clinicaladvisor.com]

Prevention

  • Discussion on the treatment and preventive measures of common gynecological diseases. Guide of China Medicine,2013,11(10):526. 27 Rong X. Self-care of patients with chronic pelvic inflammatory disease. Family Medicine,1999(3):7.[degruyter.com]
  • Prompt treatment of chlamydia and gonorrhoea infections is essential for the prevention of potential PID. In Australia, rates of chlamydia and gonorrhoea diagnoses are highest among 15- to 24-year-olds.[theconversation.com]
  • Resources: Division of STD Prevention (DSTDP) Centers for Disease Control and Prevention - www.cdc.gov/std CDC National Prevention Information Network (NPIN) 1-800-458-5231 - www.cdcnpin.org American Sexual Health Association (ASHA) 1-800-783-9877 - www.ashastd.org[healthcenter.indiana.edu]
  • The cervix produces mucus that normally prevents bacteria from spreading to the upper reproductive tract.[medbroadcast.com]
  • Prevention of PID To prevent PID or a reinfection, your sexual partner should be examined and treated. Sexual intercourse should be avoided until treatment is completed and tests indicate that the infection has cleared.[utswmedicine.org]

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