Combination of Inflammation of ovary and fallopian tube

1. z
Adnexitis
By-Deepika gupta
Group-633

3. z
Oophorosalpingitis
 Combination of inflammation of the fallopian
tubes (Latin Tuba uterina , Greek salpinx ,
inflammation salpingitis ) and the ovary (Latin
ovary , Greek oophoron , inflammation
oophoritis ). The term oophorosalpingitis can
also be used as a synonym for adnexitis

4. z Etiology
 Pathogen
 Chlamydia
 Mycoplasma
 E. coli
 Gonococci
 Staphylococcus aureus
 Streptococci

5. z
 Enterococci
 Klebsiella
 other anaerobes
 Clostridium perfringens
 rarely also tuberculosis pathogens ( Mycobacterium
tuberculosis )

7. z
Pathogenesis
 As a rule, these are germs that ascend into
the fallopian tubes via the vagina and uterus.
Often there is also inflammation in the area
of ​​the cervix (cervicitis) and the lining of the
uterus (endometritis). This inflammation is
often found shortly after menstruation or
shortly after ovulation (ovulation). At this time,
the mucus in the area of ​​the cervix (cervix) is
softened and therefore more pervious. The
maximum age is between 15 and 20 years.

8. z
Clinical symptoms
The patients usually complain of acute onset, laterally
accentuated lower abdominal pain, postmenstrual or
periovulatory . If there is accompanying inflammation in
the area of ​​the cervix ( cervix uteri ) or the uterus, there
is also discharge (fluorine) or spotting . In the case of
severe infections, vomiting and ileus symptoms can also
occur. It is not uncommon for inflammation caused by
chlamydia to be accompanied by perihepatitis ( Fitz-
Hugh-Curtis syndrome ). There are pain in the right
upper abdomen and a slight increase in liver enzymes .
Adnexitis can cause an acute abdomen .

9. z
Diagnosis
 Evaluation of history, predisposing factors, complaints
 Gynecological examination – On palpation , uterine
and adnex pressure pain and portio- push pain are
found
 During the speculum examination, inflammation of
the cervix can be shown and smears can be taken for
microbiological determination of the germs.
 Blood count – In blood count one can leukocytosis ,
fibrinogen and CRP increase notice cytological smear
to rule out malignancy in the cervical canal or uterus
with obstructoneion to drainage and secondary
inflammation .

10. z
 Urine analysis
 Bacteriological and bacterioscopic analysis - During the
speculum examination, inflammation of the cervix can be shown
and smears can be taken for microbiological determination of
the germs
 In ultrasound , can be provided so as abscesses , swelling and
secretions Behave find.
 In the case of acute illness with an unclear genesis, a
laparoscopy or pelviscopy with intraoperative surgery can be
used as a last resort

11. z
Treatment
 Since most adnexitis today are caused by chlamydia ,
an uncomplicated and outpatient treatable adnexitis
is initially treated with tetracyclines or
fluoroquinolones for at least 10 days. If therapy fails,
therapy with cephalosporins and metronidazole is
initiated. In the event of further therapy failure, an
attempt should be made to preserve the triggering
germ and a germ-specific antibiotic therapy should be
started. Abscesses are usually approached and
relieved in the hospital and surgically. Pain is
addressed with anti-inflammatory drugs (e.g.,
diclofenac ).

12. z
Complications
 Sterility : The formation of scars and structures due
to adhesions can lead to obstructive
sterility.Adhesions and accumulation of secretions (
hydrosalpinx , hematosalpinx , pyosalpinx
(saktosalpinx), dysmenorrhea )
 Tubo- ovarian abscess : encapsulated inflammatory
focus with involvement and caking of the fallopian
tube and ovary
 Douglas abscess : encapsulated inflammatory focus
in the area between the rectum and uterus ( Douglas
space )

13. z
 Peritonitis : life-threatening breakthrough of the
purulent inflammation in the free abdominal cavity
 sepsis
 Chronic Adnexitis: Symptoms of chronic adnexitis are
often bland. Often there are pelvic discomfort and
pain during sexual intercourse ( dyspareunia ). There
may also be chronic discharge. It is difficult to treat
therapeutically, as adhesions are often the cause of
the symptoms.