Pelvic inflammatory mass

　　The vast majority of pelvic inflammatory masses originate from acute salpingitis. Due to the spread of inflammation, the fallopian tubes, ovaries, uterus, omentum, and intestines are adhered together, which is the origin of pelvic inflammatory mass.

　　Pelvic inflammatory mass can cause adhesion of the uterus and surrounding tissues, such as the formation of mass due to intestinal adhesion, reduced peristalsis of the intestines, poor blood supply, which can eventually lead to intestinal obstruction and ischemic necrosis of the intestines. Once intestinal perforation occurs, it will lead to diffuse peritonitis in the abdomen.

　　The vast majority of pelvic inflammatory masses originate from acute salpingitis. The common clinical manifestations are as follows:

　　1. Lower abdominal pain

　　When the pelvic mass increases, the pain also increases, but it is generally bearable. The specific manifestation is intermittent pain and dull pain in the lower abdomen.

　　2. Abdominal pain during the menstrual period

　　Abdominal pain can also worsen during the menstrual period, but it is not as obvious as dysmenorrhea caused by endometriosis.

　　3. Increased leukorrhea

　　Patients can have increased leukorrhea and reduced lower abdominal pain after a while.

　　Effective prevention can effectively reduce the occurrence of diseases. Then, how to prevent pelvic inflammatory mass?

　　1. Eliminate various infection routes, keep the perineum clean and dry, wash the external genitalia with clean water every night, use a separate basin for each person, and never use hands to scoop the vagina, nor use hot water, soap, etc. to wash the external genitalia. During pelvic inflammatory disease, there is a lot of leukorrhea and thick consistency, so change underwear frequently, do not wear tight or synthetic fiber underwear.

　　2. There is bleeding from the vagina during the menstrual period, after artificial abortion, and after the insertion or removal of the ring in gynecological surgery. It is strictly forbidden to have sexual intercourse, swimming, bathtub, or sauna bath. Change sanitary napkins frequently, as the body's resistance is reduced at this time, and pathogenic bacteria are easily侵入, causing infection.

　　3. Patients diagnosed with acute or subacute pelvic inflammatory disease must follow the doctor's advice and actively cooperate with treatment. Patients should rest in bed or take a semi-recumbent position to facilitate the localization of inflammation and the excretion of secretions. Chronic pelvic inflammatory disease patients should also not overwork, combine work and rest, and moderate sexual activity to avoid exacerbation of symptoms.

　　4. Fever patients usually sweat a lot when they are recovering from fever. Pay attention to keeping warm and maintain body dryness. Change clothes and pants when sweating, and avoid air conditioning or direct blowing of cross-ventilation wind.

　　5. Pay attention to the quantity, quality, color, and smell of leukorrhea. A large amount of leukorrhea with yellow color, thick consistency, and foul smell indicates a severe condition. If the leukorrhea changes from yellow to white (or light yellow), the amount decreases from more to less, and the smell tends to be normal (slightly acidic), it indicates that the condition has improved.

　　6. Patients with acute or subacute pelvic inflammation should maintain smooth defecation and observe the nature of stool. If there is pus in the stool or a feeling of urgency, they should go to the hospital immediately to prevent the rupture of the intestinal wall of pelvic abscess, causing acute peritonitis.

　　7. Some patients. Due to chronic pelvic inflammation, when they feel a slight discomfort, they take antibiotics on their own, and long-term use can lead to vaginal flora disturbance, resulting in increased vaginal discharge,呈 white curd-like leucorrhea. At this time, they should go to the hospital for treatment immediately to rule out candidal vaginitis.

　　8. Patients with pelvic inflammation should pay attention to dietary adjustment and care; they should strengthen their nutrition. During the fever period, light and easily digestible food should be eaten, and for patients with high fever and injury of body fluid, peach juice, apple juice, watermelon juice, etc. can be given for drinking, but not after chilling.

　　9. Good contraception work should be done to minimize the trauma of induced abortion. Strict aseptic operation should be carried out during surgery to prevent the invasion of pathogenic bacteria.

　　10. For patients with chronic pelvic inflammation and abdominal mass, the treatment with traditional Chinese medicine enema is very effective, as it has the effects of promoting blood circulation and removing blood stasis, softening hardness and dispersing nodules, clearing heat and detoxifying, or warming the uterus and dispelling coldness.

　　To confirm the diagnosis of pelvic inflammatory mass, general examinations need to be carried out below:

　　1. Blood routine

　　Blood routine shows an increase in white blood cell count. Red blood cell sedimentation rate increases, >40mm/h, and after a long course of disease, blood count and erythrocyte sedimentation rate are often within the normal range.

　　2. Bacterial culture

　　Bacterial culture is beneficial to differentiate the nature of inflammation, thus treating the symptoms accordingly.

　　3. Drug sensitivity test

　　Drug sensitivity test is beneficial to understand the dosage of medication and the treatment method.

　　4. Laparoscopy

　　Laparoscopy is helpful for the diagnosis of pelvic masses.

　　5. Pelvic B-ultrasound examination

　　Pelvic ultrasound can show a mass on one or both sides of the uterus, with unclear outline, dense echo around it, no echo inside the mass, and clear boundary between the mass and the uterus.

　　6. MRI examination

　　Pelvic inflammatory mass can occur at any position in the pelvis, but it is more common in the appendage area, with irregular shape, adhesions around it, but not infiltrative, with uneven internal signal, and often shows overall enhancement on enhanced scanning. MRI examination can clearly show the size and location of the mass.

　　Reasonable diet plays an important role in the recovery from diseases. So, how should patients with pelvic inflammatory mass diet?

　　1. It is recommended to eat more lean meat, chicken, cabbage, asparagus, celery, eggs, crucian carp, turtle, spinach, tofu, kelp, cucumber, winter melon, mushrooms, seaweed, and fruits etc.

　　2. Mainly consume light and easily digestible foods such as red bean, mung bean, winter melon, dolichos lablab, coix seed, and porophyllum etc. It is advisable to eat foods that have the effects of promoting blood circulation, regulating qi, and dispersing nodules, such as peach kernel, persimmon skin, tangerine kernel, tangerine peel, hawthorn, rose, and tangerine etc. Appropriate protein supplement can be obtained from lean pork, duck, goose, and quail etc.

　　3. Pay attention to dietary adjustment and care, and strengthen nutrition. During the fever period, it is advisable to eat light and easy-to-digest food. For patients with pelvic inflammatory disease who have high fever and injury to the body fluid, pear juice, apple juice, watermelon juice, etc., can be given for drinking, but they should not be chilled before drinking.

　　4. Patients with cold stagnation syndrome, such as cold pain in the lower abdomen, aversion to cold, and waist pain, can be given ginger soup, brown sugar water, and longan meat, etc., as warm foods. Patients with kidney yin deficiency, such as restlessness of the five interiors and waist pain, are more likely to eat meat and egg products rich in blood and flesh, to nourish and strengthen the body.

　　According to different specific conditions, patients with pelvic inflammatory mass need to adopt different treatment methods.

　　1. General Treatment

　　Relieve the patient's mental concerns, enhance the confidence in treatment, increase nutrition, eat more fresh fruits and vegetables rich in vitamins, exercise reasonably, pay attention to the combination of work and rest, and improve the body's resistance.

　　2. Physical Therapy

　　Warm benign stimulation can be used to stimulate local blood circulation in the pelvis. Improve the nutritional status of tissues, enhance metabolism, and facilitate the absorption and regression of inflammation. Common methods include shortwave, ultrashortwave, iontophoresis, paraffin therapy, etc.

　　3. Drug Treatment

　　1. Drug: When using anti-inflammatory drugs, α-chymotrypsin or hyaluronidase can also be used simultaneously, and intramuscular injection is recommended.

　　2. Function: To facilitate the absorption of adhesion and inflammation.

　　3. Contraindications: Discontinue the drug if allergic reactions occur locally or systemically in some patients.

　　4. Other: In some cases, antibiotics and dexamethasone are used simultaneously, oral dexamethasone, and when stopping the drug, attention should be paid to gradually reducing the dose.

　　4. Surgical Treatment

　　1. Indications: Surgical treatment is feasible for patients with masses such as hydrosalpinx or ovarian cysts; surgical treatment is also recommended for patients with small infection foci that repeatedly cause inflammation. Generally used for patients over 40 years old with recurrent pelvic inflammatory disease. The ovarian function of young women should be preserved as much as possible.

　　2. Surgical Methods: Surgery is based on the principle of complete cure, avoiding the chance of recurrence of residual lesions, and performing unilateral salpingo-oophorectomy or total hysterectomy with bilateral salpingo-oophorectomy. Single therapy is less effective, and comprehensive treatment is recommended.