Among all the inflammatory processes of the female reproductive organs, the most common is salpingo-oophoritis - an inflammatory process in the fallopian tubes and ovaries. Diseases can be caused both by specific pathogens, such as staphylococci, streptococci, Escherichia, and so on, as well as by non-specific pathogens, the representatives of which are most often sexually transmitted diseases. The main danger of salpingo-oophoritis lies in the possible complications of the process, such as the spread of infection to all pelvic organs and its generalization, as well as the occurrence of adhesive processes in the cavity of the fallopian tubes, leading to infertility.
Dissemination of the infectious process in acute salpingo-oophoritis
In acute salpingo-oophoritis, the inflammatory process occurs first in the fallopian tube. Its mucous membrane is affected, then the infectious process tends to spread to the muscular and serous membranes of the fallopian tube. Due to the peculiarities of the structure of the fallopian tube, namely its free pairing with the pelvic cavity, the infectious process can spread to the corresponding ovary, as well as to the pelvic peritoneum - pelvioperitonitis occurs. This is a serious condition that requires immediate medical or, more commonly, surgical treatment. If inflammatory exudate accumulates in the cavity of the fallopian tube, a kind of saccular protrusion occurs - sactosalpinx, the suppuration of which is called pyosalpinx. In accordance with this, the following forms of salpingo-oophoritis are distinguished:
- the first is salpingitis, in which there are no signs of involvement in the infectious process of the pelvic peritoneum;
- second - salpingitis with signs of inflammation of the pelvic peritoneum;
- third - occlusion of the fallopian tubes and the development of a tubovarial tumor;
- fourth - rupture of tubovarial tumor.
Clinical picture of acute salpingo-oophoritis: main symptoms
The clinical picture of the disease is nonspecific, which can complicate the diagnostic process. In the first form of salpingoophoritis, the patient is concerned about a slight violation of the general condition and pain in the lower abdomen. At the same time, a slight leukocytosis and an increase in the ESR level may be observed in laboratory tests. When the pelvic peritoneum is involved in the infectious process, pain in the pelvic area becomes much more pronounced, chills and dysuric manifestations appear. In laboratory tests, leukocytosis is determined with a shift of the formula to the left and a significant rise in ESR, acute phase proteins are determined. If a tubovarial tumor is formed, the clinical picture of the disease may resemble appendicitis, as the symptoms of muscular protection, abdominal pain during palpation are determined. During gynecological examination, enlarged edematous uterine appendages are determined, with limited mobility and painful on palpation. A tubovarial tumor is palpated as a sharply painful mass next to the uterus.
What methods are used to diagnose acute salpingo-oophoritis
Diagnosis of acute salpingo-oophoritis is based on gynecological examination data and anamnesis. The results of laboratory studies confirm the presence of an inflammatory process in the body. Ultrasound is most informative when using transvaginal probes and can provide information about the condition of the fallopian tubes. The most informative diagnostic method for acute salpingo-oophoritis is diagnostic laparoscopy, with which you can not only clarify the prevalence and nature of the infectious process, but also immediately treat acute salpingo-oophoritis.
What methods are used to treat acute salpingo-oophoritis
For the treatment of acute salpingo-oophoritis, both conservative and surgical methods of therapy are used. Therapy is started with the appointment of a combination of several broad-spectrum antibacterial drugs, in parallel with this, the pathogen and its sensitivity to antibiotics are determined, in accordance with which the prescribed therapy regimen is adjusted. In addition, from conservative methods of treatment, for the treatment of acute salpingo-oophoritis, the use of anti-inflammatory, analgesic, detoxifying, desensitizing and immunomodulatory drugs is recommended. Surgical methods of treatment begin with a targeted puncture of the tubovarial space, through which pus is evacuated and the cavity of the fallopian tubes is washed with aseptic and antiseptic solutions. Targeted puncture is recommended to be performed under ultrasound guidance. More effective is the laparoscopic method of treating acute salpingo-oophoritis. In the most severe cases, more extensive laparotomy surgical treatment is used. With timely diagnosis and effective treatment of acute salpingo-oophoritis, chronicity of the process and the development of serious complications of this disease can be avoided.
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