Puncture of the posterior vaginal fornix - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Gynecology

This procedure is used to confirm the diagnosis of ectopic pregnancy, uterine rupture and other internal organs;to confirm or exclude the diagnosis-pelvioperitonita and general peritonitis;to determine the nature of exudate saccular tumors of the ovaries and fallopian tubes (only in case if there is no suspicion of their malignant transformation).Puncture of the abdominal cavity through the rear of the vaginal vault can be made from a therapeutic target for inflammatory exudate extraction and administration of antimicrobials, as well as a preliminary step before colpotomy (at the back of the parameter) or before laparocolpotomy (in abscess recto-uterine pouch).

Getting to puncture the abdominal cavity through the back of the arch, it should be remembered that this operation is very painful.Before the surgery, if possible, should be emptied the rectum and bladder necessarily, the vulva and the vagina to treat 70% ethyl alcohol and 1% alcoholic solution of iodine.Exposing the cervix, do not grasp it with

forceps.Much more convenient to take a neck lift to the pubic symphysis.At the same time the rear wall of the vaginal vault is stretched between the lift and mirror.Before puncture rear vaginal vault tissue infiltrate necessarily 1-2% lidocaine injection via a thin needle.After waiting for 3-5 minutes until the Novocain will work, long injection needle easy, but a sharp thrust pierced the back of the vaginal vault is strictly in the midline and the syringe is aspirated available in rectouterine fluid recess.Position in the puncture needle should be horizontal or needle should be directed slightly upwardly so as not to puncture the rectum.If an ectopic pregnancy is usually defibrinated blood is aspirated.However, just started internal bleeding from the abdomen can be obtained blood fibrin which has not yet had time to fall.This blood coagulates quickly as blood obtained from a vessel.In some cases, nothing can not suck, although the blood in the peritoneal cavity exists.This is usually explained by the needle thrombosis blood clot, which can be pushed out of the air needle with a syringe on gauze and see, you can also push a blood clot from the needle stylet.Obtaining a blood clot as defibrinated blood, is enough to confirm the diagnosis of ectopic pregnancy.Sometimes I fail to suck blood from the fact that the shear needle sticks to any fabric and covers the needle lumen.In such cases, you should dial into the syringe a few milliliters of sterile solution of novocaine or isotonic sodium chloride solution, enter it into the abdominal cavity and immediately suck.If there abdominal blood aspirated liquid will be colored with blood, it will home's small pieces clots.

Just produce a therapeutic puncture of the abdominal cavity through the rear of the vaginal vault.However, if the inflammatory exudate is very thick consistency, in the abscess should inject a sterile solution, such as isotonic sodium chloride solution, and suck the now diluted exudate.The fluid is sent to direct microscopic and bacteriological examination.