TAILIEUCHUNG - Chapter 124. Sexually Transmitted Infections: Overview and Clinical Approach (Part 14)

Perihepatitis and Periappendicitis Pleuritic upper abdominal pain and tenderness (usually localized to the right upper quadrant) develop in 3–10% of women with acute PID. Symptoms of perihepatitis arise during or after the onset of symptoms of PID and may overshadow lower abdominal symptoms, thereby leading to a mistaken diagnosis of cholecystitis. In perhaps 5% of cases of acute salpingitis, early laparoscopy reveals perihepatic inflammation ranging from edema and erythema of the liver capsule to exudate with fibrinous adhesions between the visceral and parietal peritoneum. When treatment is delayed and laparoscopy is performed late, dense "violin-string" adhesions can be seen over. | Chapter 124. Sexually Transmitted Infections Overview and Clinical Approach Part 14 Perihepatitis and Periappendicitis Pleuritic upper abdominal pain and tenderness usually localized to the right upper quadrant develop in 3-10 of women with acute PID. Symptoms of perihepatitis arise during or after the onset of symptoms of PID and may overshadow lower abdominal symptoms thereby leading to a mistaken diagnosis of cholecystitis. In perhaps 5 of cases of acute salpingitis early laparoscopy reveals perihepatic inflammation ranging from edema and erythema of the liver capsule to exudate with fibrinous adhesions between the visceral and parietal peritoneum. When treatment is delayed and laparoscopy is performed late dense violin-string adhesions can be seen over the liver chronic exertional or positional right upper quadrant pain ensues when traction is placed on the adhesions. Although perihepatitis also known as the Fitz-Hugh-Curtis syndrome was for many years specifically attributed to gonococcal salpingitis most cases are now attributed to chlamydial salpingitis. In patients with chlamydial salpingitis serum titers of microimmunofluorescent antibody to C. trachomatis are typically much higher when perihepatitis is present than when it is absent. Physical findings include right upper quadrant tenderness and usually include adnexal tenderness and cervicitis even in patients whose symptoms do not suggest salpingitis. Results of liver function tests and right upper quadrant ultrasonography are nearly always normal. The presence of MPC and pelvic tenderness in a young woman with subacute pleuritic right upper quadrant pain and normal ultrasonography of the gallbladder points to a diagnosis of perihepatitis. Periappendicitis appendiceal serositis without involvement of the intestinal mucosa has been found in 5 of patients undergoing appendectomy for suspected appendicitis and can occur as a complication of gonococcal or chlamydial salpingitis. Among women with salpingitis

• Y học thường thức
• Sexually Transmitted Infections
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• ABC of sexually transmitted infections
• Main presentations
• Male patients
• Examination techniques
• Genital ulcer disease
• Pelvic inflammatory disease
• Genital growths
• Genital infestations
• Sexual health services
• The sexual health consultation
• Clinical sampling
• Viral hepatitis
• Systemic manifestations
• Sexual health care
• Reproductive tract infections
• Hepatitis B
• Person sexual contact
• Several of these infections
• Tissue transfer
• Illustrated synopsis
• Sexually transmitted diseases
• Adverse drug reactions
• Autoimmune connective tissue diseases
• Cutaneous response
• Bacterial Infections
• Chlamydia trachomatis
• Men Sex Men
• Heterosexual Men
• Mucosal Immunity
• Clinical Approach
• Public health
• Care seeking behavior
• Global public health issue
• Pelvic inflammatory disease
• Ureaplasma urealyticum
• Human papillomavirus
• Mycoplasma genitalium
• Dermatology for the USMLE
• Melanocytic skin disorders
• Malignant skin disorders
• Selected bacterial infections
• Selected fungal infections