Post Date September, 03 2023
Tubal tuberculosis is a gynecological disease, and its occurrence should also be taken seriously, especially when a series of symptoms appear after illness, which is also the basis for our diagnosis.
Symptoms of fallopian tube tuberculosis
1. Infertility: main symptoms
2. Menstrual disorders: The length and severity of the disease are related to menstrual abnormalities.
3. Lower abdominal pain: varying degrees of abdominal pain accompanied by fever.
4. Fever: Fever occurs on physiological days and returns to normal after physiological recovery.
5. Systemic symptoms: night sweating, general weakness, severe weight loss, etc.
Tubal tuberculosis examination
1. X-ray: Digestive and urinary system examinations are performed as needed, and primary lesions are found. Gastroenterography is helpful in diagnosing tuberculous encapsulated cysts. Abdominal plain films reveal isolated calcification points in the pelvic cavity, indicating the presence of tuberculosis.
2. Uterine concrete hysterosalpingography with lipiodol: The hysterosalpingography shows multiple narrow areas in the fallopian tube cavity, which are typically beaded or show small and rigid lumens, equivalent to calcification furnaces in the fallopian tube area. When the lesion involves the endometrium or other parts of the pelvic cavity, changes in the shape of the uterine cavity, narrowing, and serrated edges can be seen. Calcification points in the pelvis, lymph nodes, ovaries, and other areas are of great help in diagnosing genital tuberculosis. However, cheese samples and tuberculosis bacteria in the fallopian tube can be brought into the abdominal cavity. Therefore, anti tuberculosis drugs such as streptomycin and isoniazid should be used before and after the imaging.
3. Laparoscopic examination or laparotomy exploration: This examination can directly observe the condition of the pelvic cavity, such as whether there are miliary nodules on the serosal surface of the fallopian tubes, adhesion around the fallopian tubes, and thickening of the fallopian tubes and ovaries. Take a biopsy at the lesion site for pathological examination, but avoid damaging the adhesive intestinal tract during the operation. If the above tests still cannot be diagnosed, a laparotomy examination can be considered.
4. Zizhen Town Endometrial Diagnosis Examination: This is the most reliable diagnostic basis. Generally, diagnostic curettage is performed within 12 hours of the menstrual source or 2-3 days before menstruation. Anti tuberculosis treatment is given 3 days before surgery and 1 week after surgery to avoid the spread of the lesion. Streptomycin 0.75~1.0g is injected intramuscularly, once a day or in two doses. Due to the fact that endometrial tuberculosis of the uterus originates from the fallopian tubes, attention should be paid to scraping off the corners of the uterus on both sides during curettage. All scraping should be sent for pathological examination, and typical tuberculosis nodules can be diagnosed. However, negative results cannot rule out tuberculosis, as fallopian tube tuberculosis can exist alone. If the uterus in Zizhen is small and hard, and tissue cannot be scraped, endometrial tuberculosis in Zizhen should be considered. If cervical tuberculosis is suspected, biopsy diagnosis should be performed.
