Inflammation of the uterine appendages (salpingoophoritis) - Symptoms

Symptoms of acute inflammation of the appendages have a pronounced picture.

Symptoms of inflammation of the uterine appendages are determined by the etiology, degree and stage of the disease, the reactivity of the patient's body. Acute salpingo-oophoritis is characterized by severe pain in the lower abdomen, especially on the side of inflammation, and an increase in body temperature. As the inflammatory process increases, the patient's condition worsens, symptoms of intoxication appear, pain intensifies and can become cramping, the temperature becomes high and is accompanied by chills, and symptoms of peritoneal irritation can be positive.

In the chronic stage of the process, the pain becomes dull and intermittent, intensifying during menstruation and physical exertion, after hypothermia. Nervous system disorders occur, and work capacity decreases.

The most severe cases of adnexitis are those caused by anaerobic infections, especially in association with E. coli and staphylococcus. Less pronounced symptoms and a more protracted course are characteristic of inflammatory processes caused by chlamydial infections and mycoplasmas.

Acute inflammation of the appendages most often affects young women who are sexually active. Currently, there is no doubt about the connection between inflammation of the appendages and the method of contraception. When using an IUD, the risk of developing acute salpingitis increases by 1.5-4 times. As for oral contraceptives, many researchers believe that their use reduces the risk of developing inflammation (according to G. Rubin et al., almost 3 times).

Acute inflammation of the appendages often begins after or during menstruation, following invasive diagnostic and treatment methods (curettage of the uterus, hysterosalpingography, hysteroscopy, hydrotubation, etc.), after surgical interventions on the genital apparatus. Patients complain of pain in the lower abdomen, radiating to the sacrum, the inner thighs, and less often to the rectum. In the presence of chlamydial and gonococcal infection, the patient may be bothered by pain in the right hypochondrium due to the development of perihepatitis, accompanying the inflammatory process of the internal genital organs (Fitz-Hugh-Curtis syndrome).

The onset of pain is accompanied by a rise in body temperature from subfebrile to hyperthermia, general weakness, headache, nausea, less often vomiting, and intestinal bloating. Most patients complain of purulent, serous, or bloody discharge from the genital tract.

Exacerbation of chronic inflammation of the appendages has a similar clinical picture, but women often associate the onset of the disease with hypothermia, heavy physical work, mental fatigue, stressful situations. Along with increased pain syndrome, this group of patients is characterized by sleep disorders, appetite, increased irritability, rapid fatigue, inadequate emotional reactions.

Formation of a purulent focus in the appendages may occur with a primary inflammatory process. This may be facilitated by: the nature of the infection (associations of microbial factors); the presence of intrauterine cysts (especially the Lipps type); concomitant genital and extragenital diseases; inadequate therapy.

However, at present, purulent inflammatory foci in the uterine appendages can form gradually as the pathological process deepens. In this case, the duration of remissions of the disease decreases and the frequency of relapses increases. Each subsequent exacerbation is more severe than the previous one: it is accompanied by a temperature reaction, chills, intoxication. Complaints from the colon arise, dysuric disorders may appear.

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