Purulent salpingitis

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

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Symptoms of purulent salpingitis

Most often, purulent salpingitis begins acutely with a rise in temperature, sometimes accompanied by chills, the appearance of pain in the lower abdomen, profuse purulent leucorrhoea and pain when urinating.

Indirect clinical symptoms indicating the likelihood of gonorrheal infection are the following anamnesis data:

• the occurrence of initial symptoms (pathological discharge, dysuric disorders) soon after the onset of sexual activity, remarriage, casual sex;
• the presence of gonorrhea in the husband, currently or in the past;
• the presence of concomitant cervicitis, urethritis or bartholinitis.

In cases where the immediate cause of acute inflammation cannot be established, the patient's medical history contains indications of the presence of chronic recurrent inflammation of the appendages.

Soon, patients develop symptoms of purulent intoxication (weakness, tachycardia, muscle pain, dry mouth), and dyspeptic, emotional-neurotic and functional disorders are added.

Suppurative Salpingitis - Symptoms

Diagnosis of purulent salpingitis

During vaginal examination of patients with acute purulent salpingitis, it is not always possible to obtain objective information due to sharp pain and protective tension of the abdominal muscles. However, the most typical signs are pain when moving the cervix, detection of pastosity or a palpable formation of small sizes with unclear contours in the area of the appendages, as well as sensitivity when palpating the lateral and posterior fornices.

It is believed that the criteria for acute inflammation of the pelvic organs are an increase in temperature, increased ESR and the appearance of 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 the cervix;
• sensitivity in the area of the appendages in combination with at least one of the following additional symptoms:
  • temperature exceeding 38 degrees;
  • leukocytosis (above 10.5 thousand);
  • pus obtained by puncturing the posterior fornix;
  • the presence of inflammatory formations during bimanual or ultrasound examination;
  • ESR>15mm/h.

Purulent salpingitis - Diagnostics

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Treatment of purulent salpingitis

The following tactical principles are fundamental: 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 relieving acute manifestations of inflammation and suppressing the aggression of the microbial pathogen, therefore drug therapy for purulent salpingitis is a basic treatment measure and includes several components.

Purulent salpingitis - Treatment