fallopian tube ovarian abscess
Introduction
Introduction to fallopian tube ovarian abscess Fallopian tube ovarian abscess is mostly developed from acute salpingitis. Inflammation causes the umbrella end of the fallopian tube to adhere to the isthmus, and the inflammatory secretions cannot be discharged, accumulating and forming the fallopian tube. Simple ovarian empyema is relatively rare. Ovarian empyema is also caused by acute salpingitis. If the fallopian tube end is not closed when acute salpingitis occurs, its purulent secretion can flow from the umbrella end into the pelvic cavity, causing extensive adhesion of the pelvic organs, the fallopian tube and ovary are surrounded by it, and gradually develop into a fallopian tube ovarian abscess. basic knowledge The proportion of illness: 0.03% Susceptible people: women Mode of infection: non-infectious Complications: infertility
Cause
Causes of fallopian tube ovarian abscess
Pathological changes:
The types of chronic tubal oophoritis can be roughly classified into four types: hydrosalpinx, tubal empyema, annexitis block and interstitial salpingitis.
1. Hydrosalpinx and tuboovarian cyst: Hydrosalpinx and tuboovarian cyst:
Fallopian tube water is caused by endometritis of the fallopian tube, which causes the umbrella end to be locked, and the exudate accumulates in the lumen. Some are for the fallopian tube empyema, part of the long-term pus absorption liquefaction, in the form of a slurry, evolved into hydrosalpinx. If the original tubal ovarian abscess, the formation of fallopian tube ovarian cysts (water).
In addition, sometimes the follicular rupture is blocked by the inflammation of the ovary to form a follicular cyst, or the bacteria rush into the follicle rupture, forming an inflammatory effusion, and later with the fallopian tube water to form a fallopian tube ovarian cyst. Hydrosalpinx is often not very large, both below 15cm in diameter, like the tubal empyema, in the shape of a curved bottle. The diameter of the oviduct ovarian water can reach 10~20cm. Both are seen in cases where inflammation does not recur for many years. The appearance is smooth, and the wall of the tube is thin and translucent due to expansion. Tubal hydrops usually have a fine membrane-like cord and a pelvic peritoneal adhesion, but are individually free. Due to the heavier distal site, the proximal end (isthmus) is the axis, and the hydrosalpinx is reversed, which is more common on the right side.
Hydrosalpinx is often bilateral. The uterus is sometimes only loose and occluded. Therefore, when the uterine tubal iodine angiography is performed, X-ray fluoroscopy or radiography can show the typical image of hydrosalpinx; a few cases complain of occasional sudden or intermittent small amount of water. Vaginal discharge may be caused by an increase in pressure in the hydrosalpinx, and the effusion may be caused by a loosely occluded fallopian tube. After a large number of vaginal discharges and pelvic examination, the original mass disappeared.
Second, fallopian tube empyema, fallopian tube ovarian abscess (pyosalpinx and tubo-ovarian abscess):
Fallopian tube empyema can not be repeated for a long time, can be repeated acute attacks. In particular, it is closely connected with the intestinal tube in the pelvis, and Escherichia coli infiltrates and is mixed with infection. When the body's resistance is weakened, the remaining fallopian tube empyema can also be stimulated by the outside world. If the patient is too tired, sexual life, gynecological examination, etc., acute attack. Before and after menstruation, local congestion can also recur.
Due to recurrent episodes, the tubal wall is highly fibrotic and thickened, and adheres to its adjacent organs (uterus, posterior ligament, sigmoid colon, small intestine, rectum, pelvic floor or pelvic sidewall). If it is stabilized after treatment, the pus can be viscous and formed into tubal hydrops. It can also become increasingly viscous and gradually replaced by granulation tissue. Even calcification or cholesterol stones can be found.
Third, the annex inflammation block (adenexitis):
Chronic fallopian tube ovarian inflammation, can be inflammatory fibrosis hyperplasia to form a more solid inflammation. Generally small, such as the intestine, the greater omentum, the uterus, the pelvic peritoneum, the bladder, etc., can form a large mass. The mass can also be formed after surgery for pelvic inflammation. At this time, the preserved organs, such as the ovary or part of the fallopian tube, the pelvic connective tissue or the sub-lust stump, the intestine, the greater omentum, etc. adhere to it. If it has become a chronic inflammation block, it is more difficult to completely dissipate the inflammation or completely disappear the mass.
Fourth, chronic interstitial salpingitis (chronic interstitial salpingitis):
Chronic inflammatory lesions left by acute interstitial salpingitis often coexist with chronic oophoritis. It can be seen that the bilateral fallopian tubes are thickened and fibrotic, and there may be small pus residuals in the muscular layer and subperitoneum. The clinical manifestations are thickening of the attachment or thickening of the cord. Microscopic examination of the fallopian tubes has extensive infiltration of lymphocytes and plasma cells.
In addition, a kind of isthmic nodular salpingitis can be formed, which is a residual of chronic inflammatory lesions of the fallopian tube. The lesion is mainly confined to the isthmus of the fallopian tube. Such cases have obvious nodules in the isthmus, and the nodules may sometimes be large, resembling small fiber-like tumors of the uterine horn. Microscopic examination of the muscular layer abnormal thickening, luminal lining folds can be involved in the muscle layer, similar to endometriosis, can be distinguished by the lack of endometrial stroma, individual muscle layer lymphocytes, plasma cells infiltration.
Prevention
Fallopian tube ovarian abscess prevention
Pay attention to personal hygiene, exercise and enhance physical fitness. Another important point is to maintain a healthy sex life, clean yourself and avoid the harm caused by unwanted pregnancy.
Complication
Fallopian tube ovarian abscess complications Complications infertility
The fallopian tube itself is invaded by the disease, resulting in obstruction and infertility, which is more common in secondary infertility.
Symptom
Tubal ovarian abscess symptoms Common symptoms Lower abdominal tenderness Lower abdomen dull pain and soreness fever
stomach ache
There are different degrees of pain in the lower abdomen, mostly hidden discomfort, soreness in the lower back and ankle, swelling, and falling feeling, often exacerbated by fatigue. Due to pelvic adhesions, there may be bladder, rectal filling pain or pain when emptying, or other bladder rectal irritation symptoms, such as frequent urination, urgency and so on.
Irregular menstruation
The most frequent menstrual frequency and excessive menstrual flow may be the result of pelvic congestion and ovarian dysfunction. Menorrhagia can be caused by uterine fibrosis, uterine insufficiency or adhesion to the uterus due to chronic inflammation.
Infertility
The fallopian tube itself is invaded by the disease, resulting in obstruction and infertility, which is more common in secondary infertility.
Dysmenorrhea
Due to pelvic congestion, it becomes a bloody dysmenorrhea. Most of the time, there is abdominal pain in the first week before menstruation. The more the menstrual period, the heavier the menstrual period.
other
Such as increased vaginal discharge, painful intercourse, gastrointestinal disorders, fatigue, labor affected or not durable, mental symptoms and depression.
Examine
Examination of fallopian tube ovarian abscess
1. Gynecological examination: It can be found that the posterior uterus is restricted in activity. The uterus may have cystic mass on one side or both sides, owing to activity and tenderness.
2. B-ultrasound examination: liquid dark areas can be found on one side or both sides of the uterus. The wall of the capsule is thick and the surrounding boundary is unclear.
3. Fallopian tube angiography: combined with infertility should be checked for inflammation of the fallopian tube after inflammation control.
4.CA125: Identification with other pelvic tumors.
Diagnosis
Diagnosis and differentiation of fallopian tube ovarian abscess
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Different from other pelvic tumors.
