Parametritis, pelvioperitonit and General peritonitis

Spreading the mucous lining of pipes, gonorrhea, together with purulent content through ampullary end can penetrate into the pelvic peritoneum.
The acute phase of primetrica (nerve okolomatocnah peritoneum), and pelvioperitonit (inflammation of the pelvic peritoneum) is characterized by edema and serous soaking fabrics with exudate. If gonorrhea is most often seen sero-fibrinous exudate, which is due to the large number of fibrin leads to the rapid formation of adhesions, promoting osmawani of exudate in the pelvis.
If it takes formed a little, and he quickly samkovaya, gonorrheal process is limited to red space and areas bordering the uterus (exudative parametritis or periodicit). If in the process involves the whole pelvic peritoneum, the amount of exudate increasing, and in cases of sepsis is formed purulent pelvioperitonit.
After resorption inflammatory exudate often remain spikes and dense growths in the pelvic cavity around and appendages of a uterus. Often such bridges lead to the displacement and wrong with the provisions of the uterus.
As for the symptomatology, it should be noted that the penetration of the infection in the pelvic peritoneum, as a rule, is accompanied by the rapid reaction (sharp pain, fever, nausea, vomiting, stool retention). Pulse Ochsen, but corresponds to the temperature; chills usually not the case; symptom Shchetkina - Blomberg, pronounced at the beginning, soon disappears. The acute phase lasts about a week and goes in subacute, continuing depending on the severity of the process from 3 to 6 weeks. When suppuration exudate disease is delayed even longer. Often parotitis gives relapses.
In extremely rare cases of gonococcal infection may spread beyond the pelvis and lead to a General inflammation of the peritoneum - diffuse peritonitis. Most often this is due to the opening of pyosalpinx or pivarium in the abdominal cavity and the abdominal cavity becomes infected pus, which contains gonorrhea.
Symptoms while in General the same as when gonococcal the pelvioperitonit: the temperature is very high numbers and kept at the same level. Pulse sufficient filling, rhythmic, 120 to 130 beats per minute. By special heart abnormalities are observed, the blood pressure is not changed. Breathing significantly casino and reaches 40 per minute, which depends solely on the sharp pain of the peritoneum. In the study draws attention to the little distended or completely flat stomach with a very sharp pain. Must be able to distinguish General gonorrheal peritonitis from peritonitis caused by Streptococcus. When the last significant General lethargy, muddy sunken eyes, zastivshie nose ("Hippocratic" person), pulse frequent, soft, irregular, with interruptions, a blood pressure below normal. Belly swollen and a little painful; breathing casino because of the high standing of the diaphragm due to bloating guts delayed gases; continuous vomiting.