Salpingitis - this is an isolated infectious-inflammatory disease of the uterine (fallopian) tubes, one or two-sided nature, often leading to its obstruction and thus infertility.As an isolated inflammation salpingitis uncommon, in most cases, inflammation of the area fallopian tubes goes to the ovaries (oophoritis), and acquires the features of a combined inflammation of the appendages (salpingoophoritis).Often inflammation of the uterus (ovaries and tubes) combined with endometritis (inflammation of the uterus).
Fallopian tubes - a paired organ, which is part of the uterus.In appearance resembles fallopian tube, each hollow tube length of 11 cm, opening into the uterine cavity in its corner at one end and into the abdomen near the ovary - from another.The lumen of the fallopian tube is coated with a special epithelial cells on the surface are arranged Education (cilia) that can make undulations (flicker).Under the layer of epithelial cells in the wall of the tube is a muscula
source of inflammatory disease is an infection of the fallopian tubes.This can be:
- Specific (gonorrheal) flora.Gonorrhoea (gonorrhea) have the ability to damage the superficial mucosal layer of the external genitalia and to penetrate into the underlying layers and tissues.The infection of the vagina rises rapidly in the cervix (cervical canal) and then into the uterus and appendages.Acute suppurative salpingitis caused by gonococci, often leads to infertility and is a threat to the reproductive health of the patient.
- Pathogenic nonspecific (negonoreyny) infection caused by chlamydia, viruses and spirochetes.
- pathogenic microflora: streptococci, staphylococci, fungi, mycoplasma, E. coli and others.Representatives of this group of microbes are present in the body of any healthy women in such quantities that it can not harm health.However, under favorable conditions, they begin to proliferate and become a source of disease.
salpingitis caused by one pathogen is extremely rare.The source of the inflammation in most cases is a microbial association.Combine in a group, pathogens more quickly and effectively develop in the tissues of the uterus and spread to surrounding structures.
Since all female sex organs are linked anatomically and functionally, the infection can get into the fallopian tubes from the vagina, cervix, uterus or ovaries.Rare are the cases of penetration into the pipes from remote infection of hematogenous (through the blood) means.
presence of infection in the body is not a sufficient condition for the onset of inflammation in the uterine appendages.The disease develops in the presence of adverse factors that reduce the body's immune defenses.
Salpingitis can occur in acute or chronic form.The most pronounced clinic has acute purulent salpingitis specific origin.Exacerbation of chronic salpingitis nonspecific nature looks as subacute salpingitis with softly pronounced symptoms.
salpingitis of any etiology have no specific symptoms.Typically, the disease has symptoms of an acute or chronic inflammation of the genital organs and verifying requires an additional localization of the pathological process using a two-handed and ultrasound examination.
salpingitis diagnosis requires laboratory confirmation.Bacteriological research sets pathogen and helps select an antibiotic to eliminate it.
as an isolated infection-inflammation salpingitis there briefly, and then the infection spreads to the ovaries and the underlying tissues.Early diagnosis of salpingitis at an early stage can prevent worsening of the disease and helps prevent complications.
Acute suppurative salpingitis can lead to serious complications: tubo-ovarian abscess formation or purulent fusion wall of the fallopian tube, the development of adhesive disease and infertility.
leading role in the treatment of salpingitis takes antibiotic therapy.Unfortunately, the presence of a large arsenal of antibacterial agents does not always help to cure salpingitis.This is only possible at the beginning of the inflammatory process, and in this period the patient does not often come to the doctor and try to cope with the disease themselves.
term "salpingitis" indicates the presence of inflammation in the fallopian tube.It is called the right-salpingitis in the event that the process is developing on the right or left sided salpingitis with the defeat of the left pipe.Much rarer sided salpingitis with the presence of an infectious-inflammatory process in both tubes of the uterus.
Some patients diagnosed as a salpingitis alter fallopian tube due to ignorance.The diagnosis of salpingitis uterine tube is similar within the meaning of the diagnosis of appendicitis appendix, is therefore incorrect and is not used by specialists.
only reason salpingitis is infection.The disease develops with the participation of those present in the body of opportunistic infections or foreign microbes trapped in the body from the outside.
The most common way in which infectious agents penetrate into the fallopian tubes and cause inflammation, passes through the uterus.A healthy woman the uterus sterile.It protects against infection cervical canal, or more precisely - the cells lining its cavity.Due to cervical glands in the cervix present large amounts of mucus.It has anti-bacterial properties and acts as a barrier to penetration of vaginal infections in the endometrium.Vaginal environment, in turn, also serves as a barrier and protective function.The composition of the vaginal microflora is a large number (98%) of lactic acid bacteria.Using them on the surface of the vagina is formed a protective layer impermeable to germs underlying tissues.Generated lactoflora lactic acid supports the constancy of pH of the vaginal environment in which infection can not reproduce.Mechanisms for local protection from genital infection is controlled hormone and the immune system.
Thus, in a healthy body tissue of the fallopian tubes is protected against infection anatomical and physiological barrier.Under certain adverse conditions defenses weaken, and the infection gets into the womb, and then - in the pipe, which begins to develop and provokes inflammation.
To develop a salpingitis:
- promiscuity.Unprotected sexual contact with a partner suffering from venereal disease, leads to the ingress of specific infections in the vagina.Especially dangerous appendages for gonorrhea.Gonokokki capable of destroying epithelial cells and cause acute, rapidly developing purulent inflammation.In addition, an intimate relationship with many partners leads to the fact that the vagina always gets a large number of alien microbial associations.Over time, they lead to a disturbance of the normal microbial balance of the vaginal environment and provoke inflammation.
- dysbiotic disorder in the vagina.A long-term imbalance between lactobacilli and opportunistic pathogens spends in the development of inflammation.
- Infectious-inflammatory diseases of the cervix (cervicitis, endocervicitis).Developing an infection in the cervix over time begins to rise to the uterus, and then - to the pipes.
- Mechanical damage to the tissues of genitals during abortions, diagnostic procedures or during childbirth.The infection penetrates the uterus and appendages of the mucous membranes through injury or surgical instruments.
- Intrauterine contraception.The infection gets into the endometrium, moving along strands of the helix, and then rises to the pipes.
indirect influence on the development of salpingitis has a strong hypothermia, stress and severe fatigue that significantly distort the natural immune defense mechanisms of the body.
- Neglect of hygiene standards.Especially it concerns the period of menstruation.Some patients do not follow the rules of vaginal tampons, changing them too seldom.Long-term presence in the vagina swab soaked with blood is an ideal source for infection.
unfavorable background for the development of inflammation of the fallopian tubes are serious endocrine and hormonal diseases, especially diabetes and thyroid disease.
to the pipes appeared infectious inflammation is not always required if any in the lower genital mutilation.In rare cases, infection in salpingitis comes in tubes uterus hematogenous (blood-borne) by the available body of foci of chronic inflammation.Salpingitis may develop in patients with tonsillitis, pyelonephritis, otitis and other similar ailments.
At the root of inflammation of the fallopian tubes are not always pathological causes.Greatly facilitates the process of microbial "contamination" of the uterus menstruation and pregnancy.Menstruating uterus inside is a large open wound vulnerable to any infection.When under the influence of adverse factors at this point in the uterus misses unwanted microflora, it easily causes the development of inflammation and subsequent rises in the tube of the uterus.
Acute salpingitis pregnancy occurs infrequently.Normally during pregnancy aggravated with chronic salpingitis.The appearance of salpingitis in pregnant women contributes to the physiological decline in immune defense and quantitative changes in the composition of the vaginal environment.
Symptoms and signs salpingitis
salpingitis clinical picture depends on the following factors:
- forms of the disease.Acute salpingitis accompanied by vivid inflammatory symptoms, and often requires hospitalization of the patient.Chronic inflammation in the tubes of the uterus during the exacerbation of subacute salpingitis looks like a dim clinic.
- The nature of the infectious agent.Acute suppurative salpingitis different bright clinic and has serious consequences, caused by chlamydia infections are asymptomatic.
- The presence of concomitant gynecological pathology.If the inflammation of the fallopian tubes takes place against the background of similar processes in other sexual organs, the symptoms of salpingitis join symptoms of opportunistic diseases and the disease will be more severe.
- The presence of complications.Acute suppurative salpingitis often provokes serious complications requiring immediate intensive inpatient treatment or even surgery.
- the immune system of the patient.In debilitated patients infection is more aggressive and more likely to cause complications.
typical symptom when salpingitis of any etiology is pain.The intensity of the pain depends on the stage of the disease.Severe abdominal pain occurs in acute salpingitis.Pain in the left groin escorted or left sided salpingitis oophoritis, and inflammation of the right-projected onto the right groin.Often the patient can not give a precise projection of the source of pain, as it is poured or radiates to the nature of the related areas, such as in the lower back.
pain in acute salpingitis are sometimes so strong that make disease like acute surgical condition.For example, sometimes a sharp right-salpingitis difficult to distinguish from acute appendicitis.
addition to the pain associated with salpingitis can raise body temperature and worsen the general condition.If the inflammatory process involved the cervix and vaginal mucosa, the patient will complain of abnormal discharge (leukorrhea) purulent serous or purulent appearance.
pelvic examination to determine the localization of the inflammatory process and the extent of its distribution, as well as to detect signs of infection of the vagina and cervix, if any.
Once in the fallopian tube, infectious agents penetrate into the thickness of its walls, as a result, it is thickened by the inflammatory edema.In the lumen of the fallopian tube it begins to accumulate inflammatory serous fluid (exudates).During this period, palpation of the uterus becomes painful.
fallopian tube in the cavity due to inflammation and exudation rapidly evolving process of adhesion of the walls.The lumen of the tube is sharply narrowed or closed, and the inflammatory exudate continues to accumulate.Thus formed hydrosalpinx.It can exist in the fallopian tube for a long time as an independent disease.When the secret becomes too much, sometimes formed the so-called ventilated hydrosalpinx he occasionally pours out of the tube into the abdominal cavity, forming adhesions or into the uterus, causing the appearance of abundant watery discharge type.
When purulent salpingitis occurs in the fallopian tube accumulation of purulent exudate, it melts the wall of the tube and ovary, forming a single cavity (abscess), filled with purulent contents.
Often patients with salpingitis worried about the possibility of pregnancy and its consequences.For most women, a bilateral salpingitis greatly reduces the chances of pregnancy.
Violation of tubal patency of the uterus due to inflammation and adhesions leading to infertility.In addition, sometimes the fertilized egg is unable to descend to the womb and implanted in the wall of the pipe and the subsequent development of an ectopic pregnancy.
salpingitis during pregnancy can take place in the presence of normal appendages on one side.Clinically salpingitis pregnancy often takes the form of a subacute or chronic process.
primary diagnosis of salpingitis causes some difficulties because of the close proximity of the ovaries.Without additional instrumental examination is not always possible to make a differential diagnosis between salpingitis and salpingo.To this end, a vaginal ultrasound scanning sensor.
Laboratory diagnostics to determine the nature of the inflammatory process and to find out its cause.Laboratory studies at salpingitis include:
- complete blood count;
- bacteriological test to identify the causative agent and determination of antibiotic to eliminate it.
- vaginal discharge smears and cervical canal.
more research methods are assigned according to the clinical situation.
Acute salpingitis begins with the appearance of severe pain.Usually, the pain occurs initially on the side of inflammation, may radiate to any area of the stomach, rectum, hip or lower back.With bilateral lesions of the fallopian tubes become diffuse nature of pain.
Acute salpingitis always worsens the general condition and fever accompanied by symptoms: high fever (above 38 ° C), chills, dizziness, palpitations and severe weakness.There may be dizuricheskie disorders, bloating and nausea.
patient with acute salpingitis often disturb abundant purulent or serous-purulent discharge, they often have an unpleasant odor.
clinical picture of acute purulent salpingitis determined by the shape of an infectious inflammation.It is a common form of uncomplicated acute purulent process in the uterine tube.Under the complicated purulent salpingitis mean all circumscribed purulent processes in the tubes of the uterus, is an inflammatory abscesses, pus-filled.Purulent inflammation of the fallopian tubes of the clinical picture resembles the symptoms of acute specific process (gonorrhea).