Mastitis

Mastitis is an acute purulent inflammation of the parenchyma and interstitium of the mammary gland. By origin, there are two forms: banal mastitis, develops with lesions of the breast - in fact it is a festering hematoma, noted in 3% of cases; and lactational (postpartum) mastitis, which is 97% of cases.

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Causes of the mastitis

The development of lactational mastitis can occur in 0.5-6.0% of parturient women and depends on measures to prevent its occurrence. More often one breast is affected, bilateral mastitis is rare. The main reason for the development of lactation masitis is milk stagnation, its fermentation, followed by infection.

[4], [5]

Stages

In the development of lactational mastitis it is necessary to distinguish several stages.

The initial (stagnant) phase, which is the starting point for the development of mastitis, is formed with insufficient evacuation of residual milk. The patient is concerned about the feeling of heaviness and bursting in the mammary gland, palpable engorged lobules, pumping painless and brings relief, there is no general reaction. If high-quality evacuation of milk is not made, as a rule, in 2-3 days develops mastitis.

1-mastitis in the stage of serous inflammation is accompanied by sharp pains in the mammary gland, an increase in its volume due to edema, widespread hyperemia, chills and high body temperature, since the milk has pyrogenic action. At palpation, the breast is hot to the touch, painful, in the depths are defined the severely injured lobules. The pathogenetic cause is the fermentation of milk. Mastitis is reversible. The main condition for treatment is the qualitative removal of residual milk in various ways: breast pump, manual decantation, it can be recommended to suction milk to adults. The child is not only possible, but also needs to be fed since this breast, since there is no pathogenic microflora in the curdled milk yet. But antibacterial drugs that penetrate into milk are prohibited for use, as the child will develop severe dysbacteriosis, and even poisoning. Local treatment consists of applying alcohol compresses, corset dressings or wearing corset linen to improve blood circulation in the mammary glands. When ineffective treatment of serous inflammation, infiltration is formed and the process passes to the second stage.

2 nd - mastitis in the stage of infiltration. Practically, mastitis is already irreversible, as the introduction of pathogenic microflora occurs. There is a decrease in pain, decreased edema and hyperemia, with a tendency to localization. When palpation in the depth of the chest is determined by the roundness of the seal (infiltration). It is elastic, dense, painful, mobile, of a uniform consistency. Given the presence of pathogenic microflora, the child is transferred to artificial feeding. In this case, a patient with mastitis can be prescribed a full range of antibacterial therapy, physiotherapy, compressive bandages with antiseptics. Lactation is blocked with hormonal drugs. But the process is very rare. Formed an apparent suppuration.

3rd - mastitis in the stage of abscessing. Pain in the chest, intensifies, acquires the character of "pulling", develops a symptom of "sleepless nights". Edema decreases, but it can be extensive, hyperemia is localized over the abscess.

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Diagnostics of the mastitis

When palpation is determined sharp soreness and softening of the infiltrate, heterogeneity of the structure; with extensive abscesses there is a symptom of fluctuations. This stage shows the opening of the abscess.

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Treatment of the mastitis

It is extremely rare, but phlegmonous and gangrenous forms of mastitis may occur, which requires radical surgery, including mastectomy.