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Clinical analysis of pelvic abscess with endometriosis

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Author:
No author available
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
3
DOI:
10.3760/cma.j.issn.0529-567x.2017.03.005
Key Word:
盆腔炎性疾病;脓肿;子宫内膜异位症;外科手术;引流术;Pelvic inflammatory disease;Abscess;Endometriosis;Surgical procedures;operative;Drainage

Abstract: Objective To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results (1) General conditions:there were no statistic differences between the two groups in age, WBC, serum CA125, intrauterine device in use, pelvic inflammatory disease history;while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations:fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12%(4/34) in the study group and 2%(2/95) in the control group (P<0.05). (3) Treatment:treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448 ± 431) versus (145 ± 24) ml]. Conclusions Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

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