Clinical manifestations of acute salpingitis

 Clinical manifestations of acute salpingitis

Etiology of acute salpingitis

1. Pathogens of pathogenic microorganisms STD, such as Neisseria gonorrhoeae, Chlamydia trachomatis, mycoplasma, viruses, etc; Nonspecific bacteria include cocci, Escherichia coli and anaerobic bacteria. It is often a mixed infection of multiple pathogenic microorganisms.

2. Weakened body resistance

(1) After abortion, postpartum, menstrual period and other systemic and local resistance is low.

(2) The measures to prevent and treat infection during invasive examination or treatment are not strict, such as diagnostic curettage, cervicitis treatment, hysterosalpingolysis, IUD implantation, etc.

(3) Infection is caused by inflammation of adjacent tissues and organs, mainly by retrograde infection of reproductive tract inflammation, such as cervicitis and endometritis; Also seen in suppurative appendicitis, peritonitis spread to the fallopian tube and other pelvic reproductive organs.

(4) Sexually transmitted diseases, such as unclean sexual intercourse, promiscuity, husband infection and sexually transmitted diseases, are repeatedly transmitted to his wife.

Pathology of acute salpingitis

The lesions of acute salpingitis are mainly intimal inflammation. If they come from acute pelvic inflammation, the lesions are extensive. The oviduct and other tissues are congested and exuded, and the purulent exudate in the cavity flows into the pelvic cavity, causing pelvic peritonitis and pelvic abscess in severe cases; Inflammation spreads to the ovary, forming tubal ovaritis or abscess; If the adhesion and atresia of the umbrella part of the fallopian tube can form tubal empyema, which is more common in the acute attack of chronic inflammation. Pathogenic microorganisms can often be found in the exudate of acute inflammation, pus and mucosal surface. If the treatment of acute inflammation is not timely or complete, it can be transformed into chronic salpingitis; Acute onset of chronic tubal inflammation is characterized by acute inflammation. With the naked eye, the fallopian tube is red and swollen, and the pelvic organs are also congested, edema, exudation and other inflammatory changes. When pressing the fallopian tube, pus can flow out, and pelvic abscess changes such as fallopian tube and ovary may be seen.

Clinical manifestations of acute salpingitis

1. Symptoms: acute onset of lower abdominal pain and distension; Frequent urination and painful urination; Purulent vaginal discharge; It may be accompanied by chills and fever, abdominal distension, constipation or diarrhea. If it occurs during the menstrual period or after abortion, the amount of bleeding increases and the menstrual period is prolonged. Ask about possible contact history of gynecological diseases or sexually transmitted diseases.

2. Signs may include high body temperature, accelerated pulse rate, muscle tension or resistance, tenderness and rebound pain in the lower abdomen. Gynecological examination can have vaginal and cervical purulent discharge, cervical congestion, easy bleeding and lifting pain. The adnexal area is tender and may touch a painful mass. A small amount of purulent fluid can be extracted by posterior fornix puncture.

3. Auxiliary examination: leukocytes in blood increased, neutrophils increased and ESR increased rapidly; There are many leukocytes in the posterior fornix fluid, and gonococcus, Chlamydia trachomatis and other pathogenic microorganisms may be detected by cervical tube smear (or culture) or PCR. B-ultrasound scan can see the liquid dark area of hysterorectal lacunae, inflammatory mass image or liquid dark area of accessory area.