Adnexitis - diagnosis and complications

What complaints and complications can occur?

The range of possible symptoms ranges from severe abdominal pain with fever in an acute infection to a slight, recurrent pulling and cycle disorders in chronic disease. Acute pelvic inflammatory disease can mimic appendicitis, it must also be excluded an ectopic pregnancy. Typical complaints, but not always and not all occur together, are in detail:

  • Acute pelvic inflammatory disease: Most common are sudden, severe abdominal pain and fever over 38 ° C. The body is often distended and tense. In addition, vaginal discharge with unpleasant odor, nausea, irregularities in bowel movements or menstruation may occur. Sometimes there is pain when urinating. The longer the infection lasts, the sicker the patients feel. The touch or movement of the uterus eg during intercourse or during gynecological examination hurts.
  • Chronic pelvic inflammatory disease: If the acute inflammation does not cure, for example because of unsuccessful therapy, or if the healing leads to scarring and adhesions, complaints persist or persist for months to years. Sufferers complain of pain in the lower abdomen or back, especially during intercourse or during menstruation, constipation or even general reduction in their performance, fatigue and loss of appetite.

Complications in the acute stage are spreading inflammation to neighboring organs such as appendix and peritoneum, which can lead to a life-threatening situation (acute abdomen). Dreaded and common is the risk that the fallopian tubes stick together. Thus, the risk for peritoneal pregnancy and infertility (sterility) is greatly increased: after the first pelvic inflammatory disease, the sterility rate is already 12%, each further doubles! This means that after four ovarian inflammations, the probability of getting pregnant in a normal way is close to zero.

How is the diagnosis made?

First, the doctor will ask questions about complaints and through illnesses. Also important are the smoking and sexual habits. In the gynecological examination with the vaginal mirror smears are taken for the microscopic examination and for breeding of the germs in a culture. In the palpation examination, uterus and fallopian tubes often feel as swollen and are painful to pressure. In addition, blood is examined for signs of inflammation; An ultrasound examination serves to exclude other diseases and to detect complications such as an abscess. If there is a suspicion of an abdominal cavity pregnancy, a pregnancy test is made. If no clear cause of the symptoms can be determined, laparoscopy may be performed.

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