tailieunhanh - Case lâm sàng sản khoa - Case 3

Tham khảo tài liệu 'case lâm sàng sản khoa - case 3', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | CASE 21 A 23-year-old GO PO woman complains of lower abdominal tenderness and subjective fever. She states that her last menstrual period started 5 days previously and was heavier than usual. She also complains of dys-pareunia of recent onset. She denies vaginal discharge or prior sexually transmitted diseases. On examination her temp is F BP 90 70 and HR is 90 bpm. Her heart and lung examinations are normal. The abdomen has slight lower abdominal tenderness. No costovertebral angle tenderness is noted. On pelvic examination the external genitalia are normal. The cervix is somewhat hyperemic and the uterus as well as adnexa are exquisitely tender. The pregnancy test is negative. What is the most likely diagnosis What are long-term eomplications that can occur with this condition I 8 2 CASE FILES OBSTETRICS AND GYNECOLOGY ANSWERS TO CASE 21 Salpingitis Acute Simiiiiarv A 23-year-old GO PO nonpregnant woman complains of lower abdominal tenderness subjective fever heavier menses than usual and dysparcunia. Her temperature is F. The cervix is hy-percmic and the uterus and adnexa are exquisitely tender. Most likely diagnosis Pelvic inflammatory disease PID . Long-term complications that can occur with this condition Infertility or ectopic pregnancy. Analysis Objectives 1. Understand the clinical diagnostic criteria of salpingitis. 2. Understand that the long-term complications of salpingitis are infertility ectopic pregnancy and chronic pelvic pain. 3. Know that one of the outpatient treatment regimens of salpingitis is intramuscular ceftriaxone and oral doxycycline. Considerations This nulliparous woman has lower abdominal pain adnexal tenderness and cervical motional tenderness. The presence of cervical motion tenderness is indirect based on the dyspareunia and hyperemic cervix. The patient also has fever. These arc the clinical criteria for pelvic inflammatory disease or salpingitis infection of the fallopian tubes . Salpingitis is most commonly caused by