Moderate pain on motion of the cervix and uterus with purulent or mucopurulent cervical discharge is found on examination. Gram-negative diplococci or positive chlamydia culture may or may not be present. WBC may be minimally elevated or normal. Symptoms more often occur shortly after the onset or completion of menses. Excruciating pain on movement of the cervix and uterus is characteristic of this condition.
Hypoactive bowel sounds, purulent cervical discharge, and abdominal distension are often present.
Gram-negative diplococci in cervical discharge or positive chlamydia culture may or may not be present. WBC and ESR are elevated. Treatment consists of bedrest, IV fluids, IV antibiotics, and NG suction if ileus is present. Since surgery may be required, transfer to a definitive surgical facility should be considered. This is continued for at least 48 hours after clinical improvement.