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Pelvic effusion is not necessarily pelvic inflammatory disease

When the physical examination report or B-ultrasound results suggest “pelvic effusion”, many women worry about whether they have pelvic inflammatory disease? How should it be treated? In fact, pelvic effusion is not as serious as expected, and in many cases it does not require treatment.

The abdominal cavity and the pelvic cavity are actually a whole, but they are artificially divided into two parts. The inner part of the pelvis is called the pelvic cavity. The lowest point of the female abdomen (pelvic cavity) is the “uterine rectal fossa”, which is formed by the peritoneum surrounding the front wall of the rectum and covering the posterior fornix of the vagina, and then covering the cervix and the posterior wall of the uterus forward and upward, forming between the rectum and the uterus Peritoneal depression. The fluid produced in the pelvic and abdominal cavity due to physiological or pathological reasons will gather to this lowest point, and the volume of this “fossa” is very small. As long as there is a small amount of fluid, B ultrasound can detect fluid accumulation in the uterine rectal fossa, and Report “pelvic effusion”.

The peritoneum has absorption and secretion functions. Under normal circumstances, a small amount of serum in the peritoneal cavity can not only lubricate the internal organs, but also resist pathogens that enter the abdominal cavity through the vagina-uterine cavity-fallopian tube, and these fluids secreted by the peritoneum flow into the uterine rectal fossa Will form “effusion”. Secondly, women of childbearing age will ovulate every month, and the follicular fluid will be discharged into the abdominal cavity along with the eggs, and the follicular fluid will accumulate in the uterine rectal fossa and form an effusion. Third, the menstrual blood of women of childbearing age can “backflow” into the abdominal cavity through the fallopian tube, thereby forming an effusion. Fourth, patients with constipation can also cause a small amount of intestinal fluid to leak out due to abnormal bowel movements to form pelvic fluid. The above-mentioned “effects” are normal phenomena and do not require special treatment.

In addition to the above physiological reasons, many pathological reasons can also cause pelvic effusion, such as careless hygiene during menstruation, inflammatory exudation of abdominal organs, rupture and torsion of pelvic and abdominal organs, cysts, ovarian hyperstimulation or gynecological surgery, pelvic and abdominal organ tumors , Liver and kidney disease, heart failure, immune disease, etc.

Pelvic inflammatory disease refers to the inflammation that occurs in the female upper genital tract organs and surrounding tissues (uterus, fallopian tubes, ovarian tissues and pelvic peritoneum), and pelvic effusion is a symptom, not a disease. Pelvic inflammatory disease may cause pelvic effusion, but pelvic effusion is not necessarily pelvic inflammatory disease. Female friends must not blindly diagnose pelvic inflammatory disease on the basis of B-ultrasound results, let alone treat blindly.

The pelvic effusion caused by physiological reasons is generally less than 2 cm, which will not cause special discomfort and can be absorbed by itself without special treatment. However, pelvic effusion caused by pathological reasons is often larger than 100 ml. Clinically, it is necessary to carefully identify the cause and treat it symptomatically.

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