Purulent salpingitis

Acute purulent salpingitis is more often specific, less often polymicrobial etiology. It develops, as a rule, as a result of gonorrhea.

[1], [2], [3], [4], [5]

Symptoms of purulent salpingitis

Most often, purulent salpingitis begins acutely with fever, sometimes accompanied by chills, the appearance of pains in the lower abdomen, profuse purulent leucorrhoea and cuts during urination.

Indirect clinical symptoms indicative of the likelihood of gonorrhea are the following history data:

• the emergence of initial symptoms (pathological discharge, dysuric disorders) soon after the onset of sexual activity, remarriage, accidental communication;
• the presence of gonorrhea in the husband now or in the past;
• presence of concomitant cervicitis, urethritis or bartholinitis.

In those cases when the immediate cause of acute inflammation can not be established, the history of patients has indications for the presence of chronic recurrent inflammation of the appendages.

Soon, patients develop symptoms of purulent intoxication (weakness, tachycardia, muscle pains, a feeling of dryness in the mouth), dyspeptic, emotional-neurotic and functional disorders join.

Purulent salpingitis - Symptoms

Diagnosis of purulent salpingitis

With vaginal examination of patients with acute purulent salpingitis, it is not always possible to obtain objective information due to the sharp soreness and protective tension of the abdominal muscles. Nevertheless, the most typical signs are painfulness when moving behind the cervix, the definition of pastosity or palpable formation of small sizes with fuzzy contours in the appendages, as well as sensitivity in palpation of the lateral and posterior fornix.

It is believed that the criteria for acute inflammation of the pelvic organs are an increase in temperature, increased ESR and the appearance of a C-reactive protein.

Diagnosis of acute purulent salpingitis should be based on the identification of the following three mandatory signs:

• abdominal pain;
• sensitivity when moving behind the cervix;
• sensitivity in the appendages in combination with at least one of the following additional symptoms:
  • temperature exceeding 38 degrees;
  • leukocytosis (more than 10.5 thousand);
  • pus obtained from puncture of the posterior fornix;
  • presence of inflammatory formations in a bimanual or ultrasound study;
  • ESR> 15mm / h.

Purulent salpingitis - Diagnosis

[6]

Treatment of purulent salpingitis

Fundamental are the following tactical principles: for any form of purulent inflammation, treatment can only be complex, conservative-surgical, consisting of:

• preoperative preparation;
• timely and adequate volume of surgical intervention;
• intensive postoperative treatment.

Preoperative preparation in patients with purulent salpingitis should be aimed at arresting acute manifestations of inflammation and suppression of the aggression of the microbial pathogen, therefore drug therapy for purulent salpingitis is a basic treatment measure and includes several components.

Purulent salpingitis - Treatment