Due to the upward spread of inflammation in the lower reproductive tract, infections such as chronic cervicitis, endometritis, and parametritis can cause inflammatory changes in the fallopian tubes. Chronic inflammation may occur due to the weak virulence of the pathogenic microorganisms, the body\’s certain resistance, or inappropriate and incomplete treatment. Acute salpingitis turns into chronic inflammation if left untreated or incompletely treated. Chronic salpingitis is often accompanied by ovarian inflammation, so it is clinically called adnexitis. The lesions vary in severity, and the following types are common:
(1) Chronic interstitial salpingitis (simple hypertrophic type). Due to long-term inflammation and the proliferation and fibrosis of the connective tissue between the fallopian tube walls, the tube wall thickens and hardens, the tube becomes thicker, and the tube lumen becomes blocked. Fallopian tube tortuosity is often inflammatory and adherent to the posterior leaf of the broad ligament, making it difficult to separate.
(2) Isthmic nodular salpingitis, characterized by nodular thickening and hardening of the isthmus, hypertrophy of the muscular layer, and island-like invasion of the endosalpinx glandular epithelium into the muscular layer It is a change of chronic inflammation; some people think that it is endosalpingiosis. The pathogenesis remains controversial. Infertility due to isthmic obstruction due to lesions.
(3) Fallopian tube pyometra may be the result of acute inflammation, or it may be caused by chronic suppuration, infection, adhesion and atresia of the fimbriae. It is characterized by thickened tube walls, obvious thickening of the tubes, thick pus in the tube lumen, pale intima, and reduced or disappeared mucosal folds. It may be combined with adhesions of ovarian abscess, broad ligament and posterior wall of uterus.
(4) The pathogenesis of hydrosalpinx is unclear. It may be due to chronic infection that causes sticky blockage of the fimbriae. Fallopian tube fluid and inflammatory exudate accumulate in the ampulla and isthmus. The wall is thick and the cavity is narrow. If there is adhesion and blockage, the fluid in the tube will be difficult to drain and will not be easily absorbed to form a gallbladder-shaped effusion. No or slight adhesion to adjacent tissues.
(5) Tuberculous salpingitis. Salpingitis caused by tuberculosis bacteria often presents as granulomatous fallopian tube. Various types of chronic inflammatory changes can be seen, such as ulcers and dryness. Type, miliary nodule type, isthmus nodule type, simple hypertrophic inflammation, you can search for Mycobacterium tuberculosis or pathological examination to find the unique changes of tuberculosis nodules. There may be systemic tuberculosis manifestations.
Patients may seek treatment with primary or secondary infertility without obvious discomfort. Some patients have dull pain in the lower abdomen, distending pain in the lumbosacral region, which worsens during menstruation, after sexual intercourse, or when tired; increased vaginal discharge on weekdays, heavy menstrual flow, prolonged menstruation, and dysmenorrhea. May have pelvic inflammatory disease andHistory of cervicitis. The symptoms are chronic quiescent salpingitis, often with no obvious signs. Some patients have tenderness in the lower abdomen or accessory area, may have cervicitis, and have excessive sticky secretions. The uterine body is often tilted backwards, fixed with adhesions, and has mild tenderness. In the accessory area, there may be ill-defined, immobile masses with irregular shapes and tenderness. . Imaging examinations mostly use B-ultrasound images, but CT scans or magnetic resonance imaging may also be used as appropriate. Images may show thickening of the fallopian tubes. Adnexal mass, fallopian tube effusion changes.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao