Endometritis
| Classification according to ICD-10 | |
|---|---|
| N71 | Inflammatory disease of the uterus, excluding the cervix - endo (myo) metritis |
| ICD-10 online (WHO version 2019) | |
The endometritis or endometrial inflammation is inflammation of the uterine lining ( endometrium ). It is a form of metropathy .
causes
This inflammation rarely occurs outside of the puerperium (see below). The pathogens are usually carried away or ascended (ascended) bacteria from the vagina. Haematogenic infection of the uterus rarely occurs . Inflammations in the area of the cervix ( cervicitis ), the vagina ( colpitis , vaginitis), tumors and an intrauterine device promote endometritis. A spread of germs can occur during diagnostic or therapeutic interventions ( iatrogenic ). In puerperal endometritis, germs are carried over from the vagina during the birth process. The puerpural endometritis can be the starting point of a puerperal sepsis (see puerperal fever ). When endometritis is combined with inflammation of the muscle wall of the uterus ( myometritis ), one speaks of uterine inflammation ( metritis )
Typical pathogens of endometritis are staphylococci , streptococci , Escherichia coli and (via hematogenous spread) also tuberculosis pathogens.
Specific forms
- Gonorrheal endometritis : inflammation caused by gonorrhea
- Puerperal endometritis : inflammation in the puerperium ( puerperal fever )
- Senile endometritis : inflammation in atrophic old age mucosa .
- Tuberculous endometritis : tubercular inflammation
- Endometritis post abortum : inflammation due to a loss of fruit ( abortion )
clinic
As a rule, patients initially have localized tenderness of the uterus ( fundus- accentuated) combined with bleeding and fever . If the inflammation spreads to the adnexa, there is usually severe pain and high fever. In terms of laboratory chemistry, the increased inflammation values ( CRP , leukocytes, etc.) are particularly noticeable.
therapy
As a rule, the inflammation is treated inpatient with broad spectrum antibiotics . Spasms and pain can be treated with butylscopolamine and anti-inflammatory drugs . If there is an accumulation of pus in the uterine cavity ( pyometra ), this must be drained , for example with a Fehling's tube. After the acute inflammatory phase, it is necessary to exclude a tumor in the area of the uterus. This is usually done with the help of a scraping ( Abrasio uteri ) and pathological diagnostics .
Complications
- Germ ascent into the fallopian tube and adnexa with the development of adnexitis
- Spread of the pathogen into the free abdominal cavity with resulting peritonitis
- Abscess formation (e.g. tubo-ovarian abscess )
- sepsis
literature
- Kay Goerke, Axel Valet: Short textbook gynecology and obstetrics . Elsevier, Urban & Fischer Verlag, 2006, ISBN 3-437-42812-8 ( full text in the Google book search).
- JW Dudenhausen: gynecology and obstetrics . Walter de Gruyter, 2002, ISBN 3-11-016562-7 ( full text in the Google book search).
