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in animals and humans, an inflammation of the uterine appendages—the fallopian tubes and ovaries. In humans the disease develops when staphylococci, streptococci, colon bacilli, gonococci, tubercle bacilli, and other pathogenic microorganisms penetrate the fallopian tubes and then the ovaries. Cocci and colon bacilli pass upward into the body from the uterus, and tubercle bacilli pass from the lungs and other organs with the blood.
Salpingo-oophoritis disturbs the continuity of the epithelium of fallopian tubes, and the tubular walls become infiltrated. The fallopian tubes and ovaries coalesce into a single inflammatory formation. The inflammation may be acute, subacute, or chronic; when it is chronic, relapses often occur. In acute cases there is pain in the lower abdomen, general malaise, and a rise in temperature to 38°-38.5°C. The lower portion of the abdomen becomes strained, and palpation produces pain. These symptoms subside when the disease enters the subacute stage. Chronic salpingo-oophoritis causes intermittent or persistent pain in the lower part of the abdomen and in the lumbus, infertility, and disruption of the menstrual cycle. Vaginal examination reveals the enlargement of uterine appendages.
Diagnosis is based on an individual’s medical history, for example, prior complications during abortions or childbirth, an irregular sex life, or incidence of pulmonary tuberculosis. A diagnosis is also based on the symptoms present and the results of instrumental and laboratory examinations. A special examination is given if gonorrhea is suspected. Hysterosalpingography, cultures of menstrual blood, and tuberculin injections are utilized to detect tubercular salpingo-oophoritis.
Treatment in the acute stage is administered in a hospital and includes rest, the application of ice to the abdomen, and the use of antibiotics, sulfanilamides, calcium-chloride preparations, and antihistaminics. Treatment is replaced by physical therapy in the subacute stage. Physical therapy is also prescribed in cases of chronic salpingo-oophoritis and includes the application of mud and the use of ultrasound and diathermy. Early treatment prevents cicatricial changes in uterine appendages and permanent infertility. Purulent salpingo-oophoritis requires surgery, and tubercular salpingo-oophoritis requires the administration of antituberculotics.
Prophylaxis is aimed at preventing the causative agents from penetrating the body during childbirth or abortion. Gonorrheal and tubercular salpingo-oophoritis are prevented by following the general rules for controlling gonorrhea and tuberculosis.
REFERENCEMnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 4. Moscow, 1963.
A. P. KIRIUSHCHENKOV