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Salpingitis

  • Female reproductive organs

Definition

Salpingitis is an inflammation of the fallopian tubes, which are long, thin ducts that connect the uterus to the ovaries and is considered one form of pelvic inflammatory disease (PID).

What is going on in the body?

Usually a woman has two fallopian tubes. Their purpose is to carry eggs from the ovaries to the uterus, and sperm from the uterus towards the ovary. This is accomplished by the action of tiny cilia that line the fallopian tubes. Cilia initially sweep the sperm and egg toward each other; the direct the newly formed embryo down the tube and into the uterus.
The inner lining of the fallopian tubes is very delicate and sensitive to any infection. Fluid, pus, or bacteria can easily cause swelling, infection, and damage in them.
The inflammation is called acute when it occurs suddenly. When it lasts for a long period of time, it is called chronic.

Risks

What are the causes and risks of the condition?

Salpingitis is caused by a bacterial infection that spreads from the vagina, cervix, or uterus to the fallopian tubes. Possible causes of salpingitis include:
  • sexually transmitted infections (STIs), often gonococcal or Chlamydial infection
  • medical procedures, such as laparoscopy, insertion of an IUD, or a dilatation zad curettage (D&C)
  • abortion
A woman who has sexual intercourse during adolescence, or who has multiple sexual partners, is at a higher risk.

Prevention

What can be done to prevent the condition?

Prevention of salpingitis is not always possible. The use of condoms during sex may decrease the risk.

Diagnosed

How is the condition diagnosed?

The diagnosis of salpingitis is based on the symptoms, the medical history, and the personal history. A pelvic exam is usually done to check for tenderness, vaginal discharge, and swelling. The healthcare provider may order additional tests, such as:
  • (hysterosalpingogram is never done to diagnose salpingitis) Do you mean a pelvic ultrasound?
  • laparoscopy, a procedure in which a thin lighted tube is inserted into the abdomen to allow the doctor to look at the fallopian tubes and other organs
  • blood tests, including a complete blood count or CBC, to check for response to infection
  • a culture of the cervical discharge and in some situations cultures of the peritoneal fluid blood cultures

Long Term Effects

What are the long-term effects of the condition?

Salpingitis can cause many long-term effects, including:
  • infertility from blocked fallopian tubes
  • adhesions or scar tissue in the fallopian tubes
  • ectopic pregnancy, or a pregnancy in which the fetus develops outside the uterus
  • chronic pelvic pain
  • recurrent pelvic infections
  • the need for a hysterectomy

Other Risks

What are the risks to others?

Salpingitis itself is not contagious and poses no risk to others. If the cause is a sexually transmitted infection, such as gonorrhea or Chlamydia infection, the infection is contagious.

Treatments

What are the treatments for the condition?

Early and prompt treatment is needed to prevent serious damage and long-term effects from salpingitis. Treatment usually involves antibiotics, bed rest, and pain medications.
Treatment may be in an outpatient setting or may require inpatient treatment if the findings are severe. The woman is often hospitalized so symptoms and treatment can be monitored.
If a woman has an IUD, it may need to be removed once antibiotics have been started. Intravenous fluids and antibiotics may be given into a vein in the arm.
Surgery may be needed to remove scar tissue or even the fallopian tube. In severe cases, the uterus, fallopian tubes, and ovaries may need to be removed.

Side Effects

What are the side effects of the treatments?

Antibiotics may cause stomach upset, headache, or allergic reactions. Surgery poses a risk of bleeding, infection, and a reaction to anesthesia.

After Treatment

What happens after treatment for the condition?

For some minor cases of salpingitis, no further treatment is needed. For more serious disease, treatment may need to continue.

Monitor

How is the condition monitored?

Close monitoring of salpingitis is needed because of the possible long-term effects. Any new or worsening symptoms should be reported to the healthcare provider.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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