6 - The fallopian tube and broad ligament

Summary

Inflammation of the fallopian tube

Inflammation of the fallopian tube (salpingitis) is a common disorder of the reproductive years. It is almost invariably infective, although minor degrees of irritative inflammation may occur as a response to the presence of necrotic tissue or blood in the tube due to, for example, menstrual reflux, bleeding from endometriotic foci or the presence of an ectopic gestation. There may also be a mild inflammatory response to foreign bodies, such as those used in sterilisation procedures.

It is difficult to determine accurately the true incidence of infective salpingitis as most cases are not confirmed either histologically or bacteriologically at the time they present and depend only upon clinical criteria for their diagnosis, particularly in the acute phase.

The term ‘pelvic inflammatory disease’ (PID) is used to encompass signs and symptoms caused by inflammation centred on the fallopian tube but extending, in many cases, to involve the ovary, mesosalpinx, parametrium, uterine serosa and uterine ligaments. In the acute phase, the clinical features are of an acute febrile illness associated with pelvic pain, vaginal discharge and tenderness over the fallopian tube. Chronic or subacute salpingitis may be recognised only when investigations for infertility are undertaken, this being a common complication of the disorder. It should be emphasised that the term PID refers only to a clinical concept and is one that should not be used as a pathological diagnosis.