The most common pathological types and diagnosis of pelvic inflammatory disease

Examination of pelvic inflammatory disease may reveal that the uterus is retroverted or biased to one side, and may be restricted or fixed in motion. One or both sides of the appendages may be thickened in a cord-like manner or have a mass, and there is tenderness. If there is hydrosalpinx or tubo-ovarian cyst, a cystic mass with restricted motion may be palpated on one side of the uterus. If there is pelvic connective tissue inflammation, there may be flake-like thickening and tenderness on one or both sides of the uterus, and the uterosacral ligament may be thickened, hardened, and tender. Sometimes patients have many symptoms but no obvious signs.

Pathology and diagnosis of pelvic inflammatory disease:

1. Pathology

(I) Chronic salpingitis is usually bilateral. Adhesions may occur to the fallopian tube mucosa, thickening and coarsening of the tube wall, closure of the fimbria, and adhesion to the surrounding tissues. There may be pus accumulation in the lumen, or abscess formation. Sometimes it may adhere to the ovary, forming a tubo-ovarian abscess. The pus in the abscess may be gradually absorbed over time, while the serous fluid continues to seep out of the tube wall and fill the lumen, forming hydrosalpinx or tubo-ovarian cyst.

(ii) Pelvic connective tissue inflammation: fibrous tissue proliferates and hardens, parauterine tissue thickens, and the uterus becomes adhered and fixed to surrounding tissues.

2. Clinical symptoms and diagnosis

(i) Lower abdominal pain, backache, distending pain in the lower abdomen, pain in the lumbar sacral region, sometimes accompanied by a distending feeling in the anus, which may be aggravated after fatigue, sexual intercourse and before menstruation;

(ii) Increased leucorrhea;

(iii) Dysmenorrhea or menorrhagia;

(IV) Primary or secondary infertility