Peritonitis, or, inflammation of the abdominal membrane, in obstetrical activity occurs most often after the implementation of cesarean section. It is considered a rather dangerous infectious disease. Based on the path of infection of the peritoneum, several types of disease have been identified. Early obstetric peritonitis appears 24-72 hours after surgery. He, often, is caused by infection at the time of surgery, performed in the presence of chorioamnionitis.
Peritonitis, which arises from intestinal paresis, develops within 3-5 days of surgery. It is caused by the appearance of motor impassability of the intestine due to deterioration of its protective functions, excessive stretching of the small intestine due to filling with liquid contents and gases.
Due to the occurrence of a problematic uterine injury, obstetric peritonitis, usually appears 4-9 days after the operation, and its separation into clinical species is quite schematic, however, it has sufficient influence on the definition of the treatment approach.
Symptomatics of obstetric peritonitis
There are three phases of the course of the disease. The initial reactive phase of the disease usually lasts 24 hours.
Symptoms of this disease include:
The therapeutic approach has a short-term effect - after 3-4 hours paresis of the intestine and other symptoms of peritonitis return.
Diagnosis of the disease
The following ultrasound signs of the disease are diagnosed: bloating and filling with hyperechoic contents of the intestinal loops, expressed hyperechoinality of the intestinal wall, the existence of fluid in the peritoneum after the intestinal loops, in the lateral canals and the area behind the uterus.
The characteristic features of peritonitis, which can be detected by means of an X-ray examination, include: hyperpneumatosis, a lot of shapeless Clauber's bowls, and sometimes - the accumulation of free gas under the diaphragm dome.
Treatment of the disease
At the initial stages of treatment of peritonitis, which appeared due to caesarean section, it is recommended to carry out treatment without surgery for a duration of 2 to 3.5 hours.
It is necessary to promote an outflow from the uterus, to make the intestine function better. If the conservative type of treatment does not give the proper result at a certain length of time, laparotomy is performed with a check of the organs in the abdominal cavity, extirpation of the uterus and appendages.