Pelvic inflammation (a study of 800 cases)
Shah, H.N.; Patel, S.; Nagpal, S.
Journal of Obstetrics and Gynaecology of India 28(3): 429-435
1978
ISSN/ISBN: 0971-9202 PMID: 12326859 Document Number: 497146
800 cases of pelvic inflammation (PI) admitted to the Civic Hospital, Ahmedabad, between October 1967 and August 1974 were studied. 772 (96.5) of these cases involved chronic PI (420 of doubtful etiology, 122 postpartum, 76 postabortal, 46 tuberculous, 33 gonococcal, and 75 postinstrumental). A further 28 cases (3.5%) represented acute PI (19 of doubtful etiology, 5 postinstrumental, and 4 postabortal). 87% of cases were 20-35 years of age. The most frequent clinical symptom was some form of menstrual disturbance (polymenorrhea, 14.87%; dysmenorrhea, 13.5%; scanty period, 11.13%; menorrhagia, 13.37%; and irregular, profuse period, 14%). 48% of the women complained of acute or chronic lower abdominal pain, and 31.1% experienced leukorrhea or purulent vaginal discharge. Sterility was found in 25% of cases. 50% of women with acute PI, 37.6% of those with chronic PI, and 6.52% of those with tubercular PI reported regular menstrual cycles. The most common organism isolated was Escherichia coli (38.45% of cases). Other organisms detected included staphylococcus (10.75%) and gonococci (8.61%). No organism was isolated in 33.78% of cases. The response to treatment with various antibiotics and cortisone was considered good in 28% of cases, fair in 37%, and poor or no response in 36%. Patients given a combined therapy of chloromycetin and corticosteroids showed early recovery and complete resolution of inflammatory masses. Follow-up study revealed that menstrual disorders were cured in 57% of cases and abdominal pain was relieved in 53%.