Female Genital System Diseases: Inflammation of Fallopian Tube and Ovary

Study Notes

Inflammation of the Fallopian Tube

Acute salpingitis is usually caused by bacterial infection, commonly due to sexual transmission (Neisseria gonorrheae, Chlamydia, Mycoplasma) and may cause infertility.
Gross features of acute salpingitis include pyosalpinx (pus), hematosalpinx, enlarged, erythematous, and edematous tubes with fibrinous exudate.
Microscopic features include marked neutrophilic infiltrate, congestion, edema, mucosal ulceration, and reactive epithelial changes.
Good prognosis, can be healed, but may lead to tubo-ovarian abscess.

Chronic Salpingitis

Results from repeated episodes of acute salpingitis.
Destroys tubal epithelium, leading to fibrosis and infertility.
May lead to ectopic pregnancy and can be superinfected with acute inflammation.
Gross features include enlarged, distorted tubes adherent to ovaries, with hydrosalpinx or pyosalpinx that transforms to a tubo-ovarian cyst.

Tuberculous Salpingitis

Usually bilateral, with hematogenous spread from primary locus elsewhere in the body (mostly lung).
Associated with young infertile patients with endometrial involvement.
Chronic interstitial salpingitis features fibrosis or mononuclear cell infiltration of all layers of the wall.
Foreign body salpingitis features giant cell formation.

Complications of Salpingitis

Tubal damage and infertility.
Ectopic pregnancy is a major complication, approximately 7-10 times more common in women who have had 1 episode of salpingitis.
Other complications include chronic pelvic pain, dyspareunia, and adhesions.

Ovaries

Almond-shaped bodies, 3cm long, covered by germinal epithelium (simple squamous).
Beneath the germinal epithelium lies the tunica albuginea, a dense connective tissue.
The cortex lies underneath the tunica albuginea, where ovarian follicles are situated.
Medulla contains a rich vascular bed in loose connective tissue.

Inflammation of the Ovary (Ovaritis/Oophoritis)

Oophoritis is an uncommonly used term for pelvic inflammatory disease (PID).
Ascending infection of the ovaries from surroundings or by hematogenous spread.
Tubes are always infected, leading to ovariosalpingitis (inflammation of both ovary and fallopian tube).
Usually acute, suppurative reaction, with tubo-ovarian abscess formation, which can rupture and lead to peritonitis.
Healing is accompanied by fibrosis, which can lead to sterility.

Complications of Ovaritis

Ruptured tubo-ovarian abscess (TOA) is a surgical emergency with a high mortality rate.
Infertility occurs in 12-15% of women after a single episode of PID.
The chances of ectopic pregnancy are increased with PID.
Chronic pelvic pain is a possible long-term consequence of PID.

Description

Learn about the inflammation of the Fallopian tube and ovary, including the structure and function of the Fallopian tubes in the female reproductive system. Understand how inflammation can impact these organs and their role in reproduction.