The efficacy of laparoscopy in adolescent girls with purulent pelvic inflammatory disease (pid)

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Material and methods. The target of medical examination of 98 adolescent girls at the age from 14 to 17 years with purulent PID was to establish the correlation between the clinical sings and the degree of destruction, revealing during laparoscopy. According to the classification of purulent PID all patients were divided into two groups. The first group (I) included 52 girls with complicated forms of purulent PID (tubo-ovarian abscess). 46 patients with simple purulent salpingitis were gathered into the second group (II). The diagnoses of purulent PID was based on the minimal, additional and definitive criteria recommended by the Center for Disease Control and Prevention. Laparoscopy was performed to all patients as definitive criteria. The degree of destruction in upper genital tract was valuated with J.Henry-Suchets’ scale.

Results. There was found out that the initial diagnoses was the same with the clinical one only in 48 (50%) patients. The diagnoses of “acute abdomen” was primarily set down in 22 (22,4%). Another 28 (28,5%) girls were hospitalized with the non-inflammatory pathology. The average duration of disease before hospitalization was 18,2 ± 2,4 days in group I and 8,4 ± 1,4 days in group I (t=3,36; p<0,001). The main symptom of 64 from 98 (65,3%) patients was lower abdominal pain. Another 10 (10,2%) girls pointed the localization

of the pain in right mezogastrium. The combined localization of the pain in hypogastrium and right mezogastrium was revealed in 13 (13,2%) cases. There were 11 (11,2%) girls which denied any sings of pain. The singular laboratory index, correlating with destruction, was the Erythrocyte Sedimentation Rate (ESR). The average ESR was 19,1 ± 1,7 mm/h in group I (n=52) and 11,8 ± 1,2 mm/h in group II. (n=46) (t =3,34; p<0,001). Laparoscopy was performed to all patients at the period from the 1-st till 11-th day of hospitalization. During the first 3 days it was made to 75 (76,5%) girls. The postponed laparoscopy was performed in 23 (23,5%) cases. The average value of J.Henry-Suchets’ index was 17,3 ± 0,5 points in group I and 15,3 ± 1,2 points in group II. The extent of surgery was varied from sanative to tubectomy, adnexectomy and appendectomy. The average duration of the hospital treatment was 11,6 ± 0,6 in the both groups. The revealed peculiarities of the purulent PID in adolescent girls demonstrate the efficacy of diagnosing of this pathology according to the minimal and additional criteria. Seeing the necessity of the performing the postponed laparoscopy in 23,5% cases we consider to be the most efficient its performance during the first 3 days that afford not only to definite the diagnoses but to perform the adequate sanation of destructed area.

About the authors

K. U. Karaeva

Saint Petersburg State Pediatric Medical University

Email: info@eco-vector.com
Russian Federation, S-Petersburg

N. A. Kochreidze

Saint Petersburg State Pediatric Medical University

Email: info@eco-vector.com
Russian Federation, S-Petersburg

G. F. Kutusheva

Saint Petersburg State Pediatric Medical University

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, S-Petersburg

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