Author/Editor     Kralj, Božo
Title     Vnetja in nekateri drugi vzroki za akutni abdomen v ginekologiji in porodništvu
Translated title     Inflammations and other causes of the acute abdomen in obstetrics and gynecology
Type     članek
Source     In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 4. Zbornik 5. mednarodni simpozij o urgentni medicini; 1998 jun 17-20; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year     1998
Volume     str. 105-14
Language     slo
Abstract     In Slovenia the number of emergency admissions for gynecologic problems has been constantly rising; in 1989 there were 3,682 and in 1994 5,036 emergency admissions. Of these women, approximately 30% were actually admitted to hospital: 78% for uterine bleeding and 10% for pelvic inflammatory diseases (PID). The acute abdomen of genital origin and acute diseases, characteristic of the first halt ot pregnancy (abortion excluded), accounts for 17% of emergency admissions. The paper deals with the causes of acute abdomen of surgical or gynecological (genital) origin, and the causes of acute abdomen occurring in the first and the second half of pregnancy. Pelvic inflammatory diseases are described in detail. The patient age is the main risk factor for development of PID. The incidence of PID is variable, ranging from 189/100000 women in the United Kingdom to 530/100000 women in the United States. PID occurs after an intrauterine surgery in 15% of women only, whereas in most women (85%), PID occurs at or after menstruation, and particularly because of the infection with sexually transmitted diseases (Neisseria gonorrhoea, Chlamydia trachomatis). Gram negative enterobacteria and anaerobic bacteria play an important role in the occurrence as well as in the choice of antibiotic treatment of PID. The route of infection is always ascendant through the vagina and the cervical canal. The complications associated with PID are bleedings, abscessus c. Douglasi, general infection leading to renal dysfunction and adult pulmonary distress syndrome, and the sequelae of PID are chronic inflammations, recurrent acute inflammation, infertility or increased incidence of ectopic pregnancy. As far as treatment is concerned, the choice of the appropriate antibiotic is extremely important. The usual combination of antibiotic treatment consists of cephalosporin of the 2nd and 3 rd generation and tetracyclines or aminoglycoside and clindamycin. (Abstract truncated at 2000 characters)
Descriptors     ABDOMEN, ACUTE
GENITAL DISEASES, FEMALE
PREGNANCY COMPLICATIONS
EMERGENCIES
ADNEXITIS