Pelvic infections: An analysis of 550 operated cases with special reference to the sedimentation test in 100 gynecologic cases

UTHSC Affiliation

College of Medicine

Document Type

Article

Publication Date

1-1-1927

Publication Title

American Journal of Obstetrics and Gynecology

Volume

14

Issue

1

Abstract

Uncomplicated acute neisserian salpingitis should not be operated upon. Cases of acute puerperal infection are best treated symptomatically, unless drainage is indicated. Patients with acute exacerbation of a chronic pelvic infection should be operated upon after the temperature has remained normal for a few days and the leucocyte count and sedimentation time coincide. Pelvic abscesses should be drained vaginally, but not laparotomized until sufficient time has elapsed to show that the condition will not clear up. Chronic pelvic infections with symptoms and masses should be operated. Where the temperature and blood findings fail to reach normal after a sufficient time has elapsed, where the abdomen is flabby, the mass localized and the physical findings warrant, surgical interference is indicated. It is difficult to evaluate the sedimentation test in so small a group of cases, yet one will be impressed with the sensitiveness of the test. While I do not believe the test should supercede the blood count, it is a valuable adjunct. In cases of doubt as to operability, where there is a quick sedimentation time, one will act wisely to delay, or hurry if operation is inevitable. It is of value in making a differential diagnosis between advanced pregnancy and simple tumors, or between an unruptured tubal pregnancy and a tuboovarian infection. In eliminating infections anywhere in the body it should prove of assistance. One can at least determine positively the absence of infection if the sedimentation time is over one hundred and twenty minutes. While at times I have noticed a variance in the temperature, leucocyte count, and sedimentation time, yet upon further study the sedimentation time could usually be substantiated. The cases of advanced normal pregnancies were suggestive examples of the value of the test. In some cases a quick sedimentation time will assist in determining an emergency operation, e.g., suspected twisted pedicle of an ovarian cyst. It is a splendid check-up diagnostic and prognostic sign in doubtful cases. While sixty minutes is very comforting to the operator, I have not found it necessary to wait for a sedimentation time of sixty minutes to operate with safety. While there were no deaths in this series, it is undoubtedly safer to wait for the sedimentation time to be above thirty minutes. The sedimentation time is of material assistance in determining the time to operate and the prognosis in pelvic infections. Frequent tests should be made to obtain the best information. © 1927.

Link to Full Text

Share

COinS