Tubal effusion

What is tubal effusion Tubal fluid by means of tubal infection after pathogens, as leukocyte infiltration forming endometrial swelling, interstitial edema, exudative, tubal epithelial shedding, if no tubal acute inflammation by timely and effective treatment on the formation of tubal empyema. Tubal empyema in the inflammation recedes, wound pus was gradually absorbed into a cavity fluid from serous purulent, a tubal fluid. Tubal pyonephrosis in a simple inflammation can be dissipated into a scar salpingits or tubal fluid, which is a common complication of chronic salpingitis, umbrella-performance for tubal occlusion and cystic expansion. With a translucent wall thinning, as intracapsular clear serous. Tubal expansion and the Department of the Ministry of luminal expansion still the same, so patients often vaginal fluid. Wall muscle atrophy or completely replaced by fibrous connective tissue, or epithelial cubic pressure was flat. Reduce mucosal folds, a small membrane intrinsic lymphocyte infiltration. Tubal effusion reasons: tubal effusion is the result of more than childbirth, abortion, sexual intercourse or unclean usually do not pay attention to menstrual health, and gynecologic surgery after the inflammation caused, but also because of the inflammation caused adjacent organs, such as appendicitis, peritonitis, etc.. Tubal effusion pathological manifestations: tubal infection with mild or moderate swelling, umbrella-can be partially or completely closed, with the surrounding tissue and adhesions. If the fallopian tubes and umbrella-inflammatory adhesion due isthmus atresia, the accumulation of serous exudative form tubal effusion; sometimes wound pus in the fallopian tube empyema gradually being absorbed, continue to serous fluid leakage from a cavity wall can be formed Tubal effusion. Effusion tubal smooth surface, very thin wall, as tubal mesangial not with effusion tubal wall and the corresponding expansion of the growth of the extension, the effusion fallopian tube bending to the side of the membrane, or a sausage-shaped neck of the bottle-shaped distillation, curl backward, and can be free or a membrane surrounding tissue sample adhesion. Reduce mucosal folds, a small membrane intrinsic lymphocyte infiltration. If tubal umbrella end result is completely closed so unreasonable impact tubal pregnancy, even if is not completely closed, often because of tubal damage effusion Ovductal, severe tubal tubal fluid can even complete loss of normal function, a reverse tubal aroused Hemorrhagic infarction, acute abdomen for gynecological reasons. Tubal effusion clinical manifestations: tubal inflammation, in patients with acute abdominal pain often history, and general tubal empyema into serous fluid or effusion that tubal absorbed by the body, inflammation often has been cured, the patients with fallopian tube effusion usually have no symptoms of abdominal pain. Because tubal fluid, and the Department of tubal expansion of the lumen of the expansion still the same, so patients often intermittent vaginal discharge liquid effusion tubal infertility often the only performance. Tubal effusion inspection: 1, Ultrasonography, part of effusion in the fallopian tube shown on ultrasound, mainly in the acute phase inflammatory tubal, tubal inflammation caused umbrella-obstruction, inflammation of the fallopian tube in the exudate of the plot lumen within the ultrasound showed that: Uterine unilateral or bilateral tubal echo abnormal thickening, and some were sausage samples, and within the lumen or a hypoechoic echo points. But the vast majority of tubal fluid is not out of the investigation. Why would we know that? By the encounter because of the effusion largely as a result of tubal infertility reasons for the inspection through the X-ray inspection by the salpingography investigation by the majority of the fallopian tube effusion of tubal fluid absorption by the body after the remaining space Shell is blind pocket expansion, is a potential expansion in the blind pocket X-ray inspection salpingography shown by the accumulation of contrast agents in the fallopian tube umbrella end of the X-ray findings. Through its ultimate diagnosis of Hysterosalpingography inspection. 2, salpingography, it is confirmed tubal effusion most reliable method, tubal fluid performance of the X-ray image is the whole tubal, umbrella-would be a clear fluid expansion, or have no part of the contrast agent-dispersion pelvic tubal umbrella. Laparoscopy can also be passed inspection, laparoscopic tubal empyema in the acute stage that Salpingitis tubal thickening of swelling, that the late-tubal umbrella atresia. Tubal effusion treatment: the adoption of Hysterosalpingography inspection or laparoscopy for diagnosis of bilateral tubal obstruction or umbrella-left side of a fallopian tube and is the umbrella-side effusion or tubal obstruction ampulla, umbrella-side tubal obstruction patients can be experienced through the fallopian tube for professional medical examination of the films Hysterosalpingography the correct reading and laparoscopic tubal observed under umbrella-lesions to determine whether suitable for a tubal stoma surgery, according to statistics, tubal fluid large diameter 3 cm, Ovductal more serious damage after tubal function recovery difficult, if endometrial situation better, can be directly carried out test-tube baby treatment, do not have to salpingostomy (tubal ostomy) treatment. Tubal-present umbrella effusion treatment menstrual clean 3-7 in the first days when done under the umbrella open or laparoscopic-ostomy, the success rate is about 20%; Second, do IVF, the success rate is about 20%. Tubal ostomy applied to the proximal tubal patency, a remote effusion, atresia patients. (1) surgical methods: abdominal stoma of endoscopic surgical tubal first fully free tubal adhesions and other organizations. The trip Hydrotubation cervix, blocking the fallopian tubes so that the distal end Peng umbrella, with no injury grasping forceps will be fixed in the uterine tubal Palace at the end. Fallopian tube openings in the original as possible with carbon dioxide laser or micro-scissors for cross incision. If unable to identify the original opening, the thinnest in the fallopian tube wall without vascular areas for the "10" characters incision. Add incision grasping forceps will be repeated several times to open a small incision satisfied. Ovarian incision direction as far as possible towards the direction for the future picking up eggs. Using non-invasive clamp seize new incision site tubal endometrium, it'll field. To open the valve to maintain the status of valgus, prevent new incision re-adhesion, available defocus laser, or low-power micro-bipolar coagulation New serosal surface of the valve open. Surface organizations to achieve the margin shrinkage valgus purposes. 4 10 can also be used to absorb the line directly to the incision in the fallopian tube valve suture valgus serosal surface. Of the continuing use of Ringer's lactate solution of heparin (5000 U / L) washing the wound. Add to the end of operation pelvic can lactate Ringer's solution, and sodium hyaluronate or antibiotics, and glucocorticoid drugs, such as spasm category in order to prevent adhesion. If found during a tubal adhesions around when feasible tubal adhesions around the separation of recovery to normal as possible physiological function, I am here to talk about another way of laparoscopic tubal adhesions around the separation of the methods of operation: Ovarian release of tubal adhesions: tubal, ovarian adhesions in infertility, chronic pelvic pain patients are very common. More from infections, endometriosis surgery and past due. Usually annex which will be fixed in the broad ligament or posterior lobe Penbi side. Tubal umbrella-often wrapped. Serious annex parcels in the womb can be rectal Waterloo, intestinal surgery vulnerable injury. Surgical methods: To enable smooth operation, to more than 3 ~ 4 abdominal puncture point. In the first one into the casing puncture, should be particularly careful to prevent intestinal adhesion, omentum causing damage. Intraperitoneal inflatable, after the success of home-should be inserted in the other subsidiary monitor casing. For intestine basins within the peritoneal adhesions, the separation should be first, and then push the intestine patients headend, when pelvic organs can be completely exposed. First to see tubal, ovarian and peripheral organs, adhesion of the nature, scope and extent. The first general release of ovarian adhesions, ovarian release after more than tubal can then free. Use of non-invasive operation should be grasping forceps to pull parts from the side, so that it maintain a certain level of tension. On the thin with no vascular adhesion can be directly used scissors cut. The thick vascular adhesion should be used with bipolar coagulation then cut off. Releasable adhesive another approach is the use of irrigation water separation. This requires special-suction pump. It can be directly adhesions from osteoporosis. For more dense adhesion between the different organs such as the bowel, ovary, stripping it can be formed in the adhesion of the surface or have the potential to facilitate the next phase of lacunar sharp separation, to reduce damage. For their ovarian and tubal adhesions, in particular umbrella end of the fallopian tube adhesion should be particularly cautious. Avoid as much as possible the surface of the ovary and fallopian tube umbrella damage. Otherwise, a new will after the adhesion. At this time, lactate Ringer's solution can be injected into the rectum Waterloo uterus, fallopian tube floating of the ovary, ovarian surface and see clearly the film adhesion tubal umbrella. Clamp adhesion with the use of micro-scissors snip. Here adhesions have no blood vessels, so try not to electricity condensate or laser. Heat can be generated because of a new injury and adhesion. Upon completion of pelvic surgery within Ringer lactate release of the crew of 150 ~ 200 ml of sodium hyaluronate or a prevention of postoperative adhesions. Below I would like to talk about my hospital open umbrella of the fallopian tube-ostomy, specific steps are as follows: 1, conventional preoperative preparation, placement catheter inserted into the vagina and the uterus of a contrast. This is in the use of angiography, to check whether the operation tubal patency and atresia of the distal fallopian tube umbrella-Peng to operational. 2, by conventional abdominal incision floors, pelvic exploration, in the surgical field to fallopian tube, from the distal fallopian tube or * do cross-shaped incision. 3, Wen-clamp gently against the edge of incision. 4, saline injection of the contrast with the blue fluid tubal patency is observed in the fallopian tube lumen mucosal folds whether rich, the health organization. 5. Ovductal'll face, in the absence of vascular wall area a short count on the longitudinal incision so as a petal-shaped umbrella or similar natural form. 6, with 4-0 absorbable sutures without injury will be carefully Ovductal serosal surface of the continuity and suture, the incision tubal no bleeding edge, and they have the natural umbrella shape. 7, reservations antibiotics, hyaluronidase, glucocorticoid and spasm of anti-adhesion, and other drugs. 8, where no conventional customs after abdominal bleeding, postoperative day trip to consolidate intrauterine injection treatment. (2) type of evaluation: The surgery itself is not complicated, difficult and less. Stoma key to the success of the new formulation of the valve in order to maintain the status of valgus, and maintain its patency. Fine surgical operation, as far as possible, to avoid tubal serous, mucous membrane causing new damage. But it was still difficult to completely avoid new postoperative adhesions. Impact depends largely on whether or not pregnancy after tubal disease preoperative the depth and breadth. If tubal adhesions or with the surrounding broad involvement of the whole wall, stiffen or endometrial thickening scar formation, even if the surgery tubal patency has been resumed, that operation is successful, but because of tubal function can not be resumed picking up eggs after pregnancy Opportunities are still small. The overall pregnancy rate of 20% after about ectopic pregnancy rate was 5% to 18%. Severe adhesions after 2002 has yet to pregnancy test-tube baby technology will be. Therefore professional doctors preoperative through X-ray films that performed the tubal reading to correctly predict functional recovery after tubal how it is a crucial. If taking into account the functional recovery after poor should abandon tubal ostomy treatment, and to avoid as much as possible to reduce the damage and the medical patients unnecessary risk. Of the operation are as follows: (1) to the surgery fine gentle with the 11th tip scissors or small anatomical separation adhesion, and abandoning Sila, and incision of the fallopian tube serous membrane damage when not in the vascular membrane to prevent the impact of blood supply. (2) any of the stoma, stoma should be some openings in the ovary, especially ampulla stoma should be more closely in order to pick up ovarian close to the egg. After treatment: (1) a broad-spectrum antibiotics for at least one week, as appropriate, with anti-histamine drug to reduce surgical site edema. (2) three days after the discretion of the trip Hydrotubation to consolidate effect, but it was not necessary-in the treatment of recurrent, increased pain and to prevent infection and obstruction umbrella-once again-led umbrella tubal rupture possible. A major complication is the possibility of ectopic pregnancy, umbrella-stoma after pregnant patients should be for early B-to exclude the possibility of an ectopic pregnancy. Why do I say that tubal umbrella-effusion stoma after pregnancy rate only 20% This issue should start end of the fallopian tube umbrella about physiological function: from the Ministry of tubal umbrella serosa, composed of smooth muscle and mucous membranes in the ampulla remote, as a distraction umbrella coverage in the ovarian surface. It is the top end of the fallopian tube abdominal openings, a diameter of 1 to 1.5 cm. Umbrella of the muscle fiber scarce, but mucosal fold rich. Ciliated epithelial cells and secretory cells. Under normal circumstances, the ciliated epithelial cells of more than 60 percent, and the movement towards intrauterine cilia, the cilia of the swing to the delivery of the egg. Pick up the egg through the fallopian tube is usually umbrella-cilia and ovarian direct contact with the surface to achieve. Then, ovary and fallopian tube ligament umbrella must be coordinated action, and ovarian and tubal mesangial mesangial together so that the ovary and fallopian tube rotation umbrella in ovarian move on the co-ordination so that the eggs can be successfully enter the fallopian tube. Therefore impact stoma after tubal pregnancy is the major factor in low inflammation may be due to tubal damage umbrella end of the fallopian tube mucosa and ciliated cells, umbrella-severe tubal fluid of patients, and sometimes even end stoma umbrella success, but also because of the destruction of cilia and the impact of the pick up their normal function thereby affecting egg fertilization. The second is the umbrella-umbrella-stoma after adhesion are once again the possibility of obstruction. Stoma umbrella-after contraception if not observed under six months of pregnancy can not redo Hysterosalpingography check to see tubal patency, such as tubal obstruction umbrella-again only do IVF. The umbrella-stoma after review by contrast tubal patency of the patients also, if the exclusion ovulation, sperm quality and the man's immune factors such as infertility observed to 2 years also should do IVF treatment. For tubal diagnosed TB, we should abandon the surgery. Bilateral Tubal CM effusion diameter of 3 or more, even after patent pipeline and its function it is also difficult recovery, little chance of conception. Drug-treatment of tubal umbrella effusion is not effective? According to our people the right to Shangqiu County, Henan Province Chinese medical professionals tubal infertility treatment group concluded many years of experience in the fallopian tube umbrella-effusion of the fallopian tube is in the early phase of acute inflammation drug treatment is effective! Then through active treatment can effectively control inflammation, prevent and reduce the lead to tubal umbrella-atresia. Most tubal umbrella may end effusion infertility patients in the routine inspection by Hysterosalpingography inspection found that the oviduct umbrella-effusion, as to when the umbrella-effusion caused a long history of Motouan ! I even patients is not clear! At this time of tubal fluid given to drug treatment efficacy can well be imagined, what is also impossible to atresia of the umbrella-tubal-eat! This is impossible! Only through artificial external (surgery) to resolve!