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21794717
DOLOR PÉLVICO CRÓNICO
Description
Mind Map on DOLOR PÉLVICO CRÓNICO, created by Brenda A CM on 02/04/2020.
Mind Map by
Brenda A CM
, updated more than 1 year ago
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Created by
Brenda A CM
over 4 years ago
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Resource summary
DOLOR PÉLVICO CRÓNICO
Def: dolor por mas de 6 m, no ciclico, en pared abdominal anterior, debajo del ombligo, disfuncioal
6-25% M en edad fertil,
CAUSAS:
Sx de Intestino Irritable6-25%
Cistitis6-25%
ENDOMETRIOSIS
LEIOMIOMAS
La fisiopatología no está clara, pero puede incluir: hiperestesia, alodinia y la disfunción del suelo pélvico
FACTORES DE RIESGO:
SALUD MENTAL: somatizacion, 8%, histeria 4%
HGYO: Cesarea previa: 3.18% EPI
VIOLENCIA DOMESTICA: abuso sexual,
SOSPECHA:
sangrado postcoital,
perdida de peso
sangrado postmenopausico
masa pelvica
hematuria
semiologia del dolor
localizacion,
ciclicidad
sintomas urinarios
patron mesntrual
dispareunia
habito intestila
EXPLORACION FISICA
Alodinia: respuesta dolorosa a estimulo inocuo.
Hiperestesia: respuesta extrema a un estimulo doloroso.
SIGNO DE CARNETT
de pie, sentada, decubito supino, litotomia
DX:
imagen: ultrasonido
BH, QS, EGO, Cultivos, PIE, Ca 125
Laparoscopia
TX:
farmacologico
AINES
4-6 semanas
Progestagenos
via oral 10 mg o IM cada 3 meses 150 mg
DIU MIRENA sospeche de endometriosis
Danazol 200-400 mg vo x 9 M
Antidepresivos tricicliclos Inhibidores de la recaptura de serotonina, anticonvulsivos
quirurgico
laparoscopia
ligamento de uterosacros (lUNA)
Neurectomia presacra
COMPLICACIONES
Daño a vena o arteria sacra media
vena iliaca primitiva izqueirda
lesion a ureter
retrencion urinaria 50%
estreñimiento cronico 90%
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