hemorrhagic salpingitis
Introduction
Introduction to hemorrhagic salpingitis Hemorrhagic salpingitis is a special type of acute salpingitis. Hemorrhage occurs in the interstitial layer of the fallopian tube, breaking through the mucosal epithelium into the lumen, and even flowing into the abdominal cavity from the umbrella end, causing blood in the fallopian tube and abdominal cavity. There are very few reports in the foreign literature of this disease. There are only a few cases of misdiagnosis in China, but the reports have gradually increased in the past ten years. It has gradually become recognized by clinicians, and it has not become a rare case, and it is a new acute abdomen in obstetrics and gynecology. one. basic knowledge The proportion of illness: 80% (the above is more than 20 women with a disease probability) Susceptible people: good for women Mode of infection: non-infectious Complications: hemorrhagic shock and encephalopathy syndrome
Cause
Causes of hemorrhagic salpingitis
(1) Causes of the disease
It is not very clear that the pathogenic microorganisms of hemorrhagic salpingitis are unknown. It may also be a subclinical infection caused by gynecological surgery, especially after artificial abortion, accompanied by cervical or intrauterine adhesions of varying degrees, leading to menstrual blood or fallopian tubes. The bleeding blood flows back into the abdominal cavity, and is also related to gynecological surgery, especially those who have had artificial abortion in the recent (2 months). It is also related to the surgeon's mild concept and rough operation; the fallopian tube patency test, small incision tubal ligation Repeated hooking during surgery, lifting the fallopian tube and so on to cause the disease, in addition, the menstrual blood reflux laparotomy when seeing the active end of the fallopian tube umbrella can not rule out hemorrhagic salpingitis.
(two) pathogenesis
It is speculated that some bacteria, especially anaerobic bacteria or viruses, may be used as conditional pathogenic microorganisms. In gynecology, family planning surgery, pregnancy, childbirth or menstruation, the body's immune imbalance may occur, causing inflammation of the fallopian tubes and causing blood vessels. Increased permeability leads to rupture of blood vessels in the interstitial layer.
Prevention
Hemorrhagic salpingitis prevention
Prevention: The consequences of acute salpingitis are more serious. Because the treatment is not timely, the delay is long and it is more difficult to cure, which is extremely harmful to women's physical and mental health. Therefore, the key to reducing the occurrence of this disease is to do preventive work as soon as possible, from the early stage, to achieve the following points, in order to prevent the invasion of pathogens.
1 When women are sexually active, they should pay attention to the personal hygiene of themselves and their sexual partners. Before the trip, it is necessary to clean the external genitalia of both men and women to prevent the smooth invasion of germs. When women have bleeding symptoms in the vagina, they should refrain from sexual life.
2 women should pay attention to their vulva hygiene and personal hygiene; pay attention to prevent infections from sanitary ware and toilets.
3 The majority of women should pay attention to their own nutrition and health care, strengthen the nutrition during menstruation, after abortion, and after childbirth; enhance their physical fitness, increase their resistance, immunity, and reduce the chance of illness.
4 need to carry out artificial abortion, childbirth, access to intrauterine device, and other official cavity surgery, should be strictly disinfected, to avoid the bacteria into the vagina and uterus by surgery, artificial infection.
5 Women with attachment diseases should follow the principle of treatment, take a positive attitude, thoroughly treat, control the disease as soon as possible, and prevent chronic changes.
Complication
Hemorrhagic salpingitis complications Complications hemorrhagic shock and encephalopathy syndrome
In severe cases, symptoms such as dizziness and palpitations can be expressed. There are also nausea, vomiting and other similar early pregnancy reactions, severe cases may have pale face, syncope. Laparoscopy showed hemorrhage in the abdomen, thickening of one or both of the fallopian tubes, congestion, edema or adhesion to the surrounding. Hemorrhagic shock may occur with active hemorrhage at the umbrella end of the fallopian tube, implantation of a tubal without tubal pregnancy, and rupture of massive hemorrhage.
Symptom
Hemorrhagic fallopian tube symptoms common symptoms menstrual bleeding ectopic pregnancy lower abdominal pain menopause persistent pain cervical pain nausea abdominal pain dizziness hypotension
1. Symptoms: Most patients have childbirth, intrauterine operation, history of gynecological examination; history of asexual life before the onset, there may be a history of menopause, mainly manifested as irregular vaginal bleeding, lower abdominal pain with anal bulge, abdominal pain begins on the abdomen side Afterwards, all the lower abdomen showed persistent pain. The time from abdominal pain to treatment ranged from several hours to 10 days. On average, 48 hours, there was a history of menopause. Most of the intra-abdominal hemorrhage did not exceed 200 ml. In severe cases, symptoms such as dizziness and palpitations may be present. Nausea, vomiting and other similar early pregnancy reactions, severe cases may have pale face, syncope.
2. Signs: fever, rapid pulse rate, lower abdominal pain, rebound tenderness, severe cases of abdominal mobile dullness positive, hypotension, gynecological examination: cervical pain, post-milk pain, attachment tenderness or thickening or Block.
Examine
Hemorrhagic salpingitis
1. Blood routine: The hemoglobin value is in the normal range, and the white blood cell count and neutrophils are elevated.
2. The urine pregnancy test is negative.
3. Microbial culture and drug sensitivity test.
4. B-mode ultrasound examination can be found in the accessory mass and peritoneal effusion.
5. After the Qianlong puncture, the non-coagulated bloody fluid is extracted, ranging from 1ml to more than 5ml. It is light red or bloody, with little dark red or old blood.
6. Laparoscopy: see abdominal hemorrhage, one or both sides of the fallopian tube thickening, congestion, edema or adhesions with the surrounding, etc., may have fallopian tube active bleeding, no implantation of tubal pregnancy and rupture of large bleeding .
Diagnosis
Diagnosis and diagnosis of hemorrhagic salpingitis
According to clinical manifestations and gynecological examinations, laboratory tests can confirm the diagnosis.
It must be ruptured with tubal pregnancy, rupture of corpus luteum hematoma, retrograde into the abdominal cavity through the fallopian tube, rupture of ovarian chocolate cyst, pelvic abscess, appendicitis.
Hemorrhagic salpingitis and tubal pregnancy symptoms are very similar, the main identification points.
