Adnexitis or salpingo-oophoritis is called the unilateral or bilateral inflammation of the ovaries and the fallopian tubes forming the appendages of the uterus.

In the structure of inflammatory diseases of the female reproductive system, inflammation of the appendages of the uterus /adnexitis/ occupies one of the first places.

Inflammation of the appendages of the uterus can be caused by streptococci, enterococci, staphylococci, gonococci, fungi, viruses, mycobacterium tuberculosis, escherichia, chlamydia and other microorganisms.

A common cause of inflammation is microbial associations, usually Escherichia coli and staphylococci. As a rule, the causative agents of the inflammation of the appendages of the uterus are resistant to many antibiotics.

Tuberculosis bacillus and gonococcus usually cause bilateral inflammation of the uterine appendages, and streptococci, staphylococci and Escherichia coli – unilaterally.

Predispose to the development of inflammation of the uterine appendages or its recurrence – overcooling, infection with sexually transmitted infections, non-observance of hygiene norms, stress and disordered sexual contacts.

What are the symptoms?

The acute form of the disease proceeds with a characteristic clinical picture: severe sharp pains in the lower part of the abdomen, extending to the anus, sacrum and stronger expressed on the side of the inflammation, fever, often accompanied by increased body temperature, unusual appearance of mucous or purulent discharge from the vagina, weakness, fatigue, diarrheic stools and bloating.

On palpation of the abdomen, symptoms of muscle protection /peritoneal irritation/ are noticeable.

Bilateral inflammation of the uterine appendages, combined with inflammation of the uterus, often develops. The disease can be accompanied by algomenorrhea and menorrhagia.

When the inflammatory changes increase, purulent sac-like tumors form in the region of the uterine appendages and subsequently tuboovarian abscess.

As the size of the abscess increases, there is a risk of it bursting, which invariably may cause the fallopian tube to rupture.

In such a case, it is very likely that the purulent contents will flow into the uterine cavity, which can become the cause of the development of pelvioperitonitis.

In the case of severe intoxication in the acute phase of the disease, changes in the nervous and circulatory system may occur.

Strongly expressed symptoms in the uncomplicated acute form of the disease last 7-10 days, and subsequently the pain sensations gradually weaken, the blood composition and body temperature normalize.

The outcome of the acute inflammation of the uterine appendages can be a complete clinical recovery, with adequate and timely treatment, or a chronification of the process with a long course.

In the development of the acute form of the disease, four consecutive stages are distinguished:

• Stage of acute endometritis and salpingitis without symptoms of inflammation of the peritoneum and pelvis;
• Stage of acute endometritis and salpingitis with symptoms of inflammation of the pelvic peritoneum;
• Stage of acute adnexitis , accompanied by the development of an inflammatory conglomerate, as well as the formation of an abscess.

The course of the acute form of the disease passes through 2 phases:

• Toxic – aerobic flora predominates and symptoms of intoxication;
• Septic – with the addition of anaerobic flora, symptoms worsen and complications develop.

In the septic phase of inflammation of the uterine appendages, a purulent tuboovarian formation is formed, and there is a very high risk of perforation.

Treatment of adnexitis

In the acute phase of inflammation of the uterine appendages, the patient is subject to inpatient treatment by creating conditions for her mental and physical rest, she is prescribed a diet that includes easily digestible foods, she is provided with adequate amounts of fluids, observing her excretory function.

For acute adnexitis, the following are prescribed: antibacterial treatment with preparations with a wide spectrum of action, pain relievers and strong anti-inflammatory medications.

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