tubal adhesions
Introduction
Introduction Tubal adhesions were light and heavy, adhesions were divided into three degrees, and the adhesion of the fallopian tube was one degree: the adhesion between the fallopian tube and the uterine horn was twice; the tubal and the umbrella were three degrees.
Cause
Cause
Cause:
(1) postpartum or post-abortion infection: the patient has weak constitution after childbirth or small postpartum, and the cervix has not been well closed after expansion. At this time, bacteria present in the vagina and cervix may infect the pelvic cavity; if there is a placenta in the uterine cavity, Residual membranes have a greater chance of infection.
(2) infection after gynecological surgery: artificial abortion, ring or ring surgery, tubal fluid, fallopian tube angiography, endometrial polypectomy, or submucosal uterine myomectomy, if the disinfection is not strict Or chronic inflammation of the original reproductive system, which may cause postoperative infection. Some patients do not pay attention to personal hygiene after surgery, or do not follow the doctor's advice after surgery, have sex, can also cause bacterial infection, causing pelvic inflammatory disease.
(3) Menstrual period does not pay attention to hygiene: endometrial exfoliation during menstruation, uterine sinus opening, and clots, which is a good condition for bacterial growth. If you do not pay attention to hygiene during menstruation, use sanitary napkins or toilet paper with unqualified hygiene standards, or have sex, it will provide bacteria with a chance of retrograde infection, leading to pelvic inflammatory disease.
(4) Inflammation spread of adjacent organs: The most common is the occurrence of appendicitis and peritonitis. Because they are adjacent to the female internal reproductive organs, inflammation can spread directly, causing pelvic inflammation in women. In the case of chronic cervicitis, inflammation can also pass through the lymphatic circulation, causing pelvic connective tissue inflammation.
Infection of the pelvis causes adhesion around the fallopian tube, which attaches the fallopian tube to the pelvic wall.
Examine
an examination
Related inspection
Oviduct patency examination X-ray lipiodol contrast oviduct phenol sulfonate patency test fallopian tube methylene blue fluency test obstetric B-ultrasound
Diagnosis: The diagnosis of the fallopian tube lumen is mainly through X-ray hysterosalpingography. The proximal tubal adhesion is mainly characterized by stenosis of the lumen and rough wall. The adhesion of the distal end of the fallopian tube is mainly characterized by thickening and expansion of the ampulla or umbrella end, distortion of the distal end, and residual film of the fallopian tube.
Adhesion around the fallopian tube needs to enter the abdominal cavity to confirm the diagnosis. It can be done by open surgery or laparoscopy. Many doctors have seen the film saying that adhesions around the fallopian tube or pelvic adhesions are inaccurate.
Diagnosis
Differential diagnosis
Differential diagnosis: Fallopian tube adhesion can be divided into adhesion of the fallopian tube lumen and adhesion around the fallopian tube. Tubal adhesions are divided into proximal tubal adhesions and distal tubal adhesions.
Indexing of tubal adhesions
Tubal adhesions were light and heavy, adhesions were divided into three degrees, and the isthmus adhesion was once: the adhesion between the fallopian tube and the uterine horn was two degrees; the tubal and the umbrella were three degrees.
The fallopian tube adheres to the adhesion of the fallopian tube lumen and the adhesion around the fallopian tube. The symptoms of different adhesion sites are different. Adhesion of the fallopian tube lumen is mainly manifested as infertility. In the acute phase, there may be abdominal discomfort, which usually manifests as infertility. If the adhesion around the fallopian tube is mildly adhesion, there is no symptom. Severe adhesion may cause long-term chronic abdominal discomfort. The pelvic attachment is thickened, the uterus activity is poor, and some have a mass or a lock. Laparoscopic adhesions around the fallopian tube can confirm the surrounding condition. The most common cause of tubal adhesions is the inflammation of the fallopian tubes at some stage, which is the sequelae of inflammation. The adhesion of the fallopian tubes is divided into adhesions in the tubal lumen and adhesions around the fallopian tubes, both of which are caused by inflammatory infections.
The most common cause of tubal adhesions is the inflammation of the fallopian tubes at some stage, which is the sequelae of inflammation. The adhesion of the fallopian tubes is divided into adhesions in the tubal lumen and adhesions around the fallopian tubes, both of which are caused by inflammatory infections.
The adhesion of the fallopian tube lumen is more common in the ascending infection along the genital mucosa, that is to say, the inflammation walks along the mucosa of the vaginal fallopian tube, which is only infected on the surface. The clinical symptoms of this infection are relatively light and many people do not feel it. Sexual infection often causes obstruction of the isthmus of the tubal interstitial, which is a good indication for tubal interventional recanalization. The infection around the fallopian tube is more common in infected bacteria along the lymphatic system. The lymphatic vessels in the vaginal and cervix wounds invade the pelvic connective tissue and other parts of the internal genitalia. It is a puerperal infection, infection after abortion and placement of the IUD. The main route of infection, this infection usually has obvious symptoms. Inflammation splashing the fallopian tube causes the serosal congestion and edema of the fallopian tube to adhere to the surrounding tissue. This inflammation can only cause infection of the serosal and muscular layers of the fallopian tube without puncturing the mucosa of the fallopian tube. When the angiography is performed, the fallopian tube can be Shows smooth. It can also be infected with the tubal lumen, which is usually very severe and has multiple obstructions.
Because tubal obstruction and peripheral adhesions are caused by previous inflammation, inflammation may have healed until tubal obstruction, so there is no obvious discomfort in tubal obstruction and surrounding adhesions, but infertility is the main reason for treatment.
In addition, endometriosis and surgery can also cause fallopian tube adhesions. For the proximal obstruction of the fallopian tube or the mild adhesion of the inferior can be treated with tubal fluid or selective tubal intubation. For the end of the fallopian tube or the surrounding adhesion, laparoscopic adhesion separation around the fallopian tube can be performed.
