Salpingitis isthmica nodosa
Updates to Article Attributes
Salpingitis isthmica nodosa (SIN) (sometimes, sometimes also referred to asperisalpingitis isthmica isthmica nodosa - PIN), refers to nodular scarring of the fallopian tubes. In very early stages, the tubes may appear almost normal. As scarring and nodularity progressesprogress, the changes become more radiographically apparent.
Pathology
Aetiology
- the aetiology of SIN has remained a matter of controversy since its first description
- the prevailing theories
includeinclude an inflammatory (salpingitis), a congenital, and more recently an acquired (but not post-inflammatory) aetiology
Location
It can involve the entire fallopian tube, but usually involves the proximal two-thirds of the fallopian tube.
Radiographic features
An accurate radiographic diagnosis is is important due to to its stronghigh association with infertility and ectopic pregnancy.
Hysterosalpingography (HSG)
A characteristic finding is multiple nodular diverticular spaces involving the fallopian tubes (usually, usually involving the proximal two-thirds of the fallopian tubes).
HSG of the nodular area with severe SIN shows several pockets (diverticulae(diverticula) containing the introduced contrast material 5.
It is observed that no dominant channel is seen as the contrast flows through the tube. This means there appears to be no direct pathway for sperm to travel which increases the chances of a tubal pregnancy.
Treatment and prognosis
Treatment can be considered with recanalisation procedures either using a catheter guided by interventional radiology or by endoscopic surgery.
Complications:
- increased risk oftubal ectopic pregnancy 4
- subfertility
History and etymology
The term is derived from salpingitis for inflammation of the salpinx (tube), isthmica for the involvement of the proximal isthmic portion of fallopian tube and nodosa for its nodular appearance.
Differential diagnosis
Considerations include include:
-
tubal tuberculosis 6
- often
multiplemultiple constrictions can form along the course of the fallopian tube due toscarringscarring, and give rise to a "beaded" appearance ofthethe tubes on HSG - can also have adnexal calcification
- often
- endometriosis
- tubal adenomyosis
-<p><strong>Salpingitis isthmica nodosa (SIN)</strong> (sometimes also referred to as <strong>perisalpingitis isthmica nodosa - PIN</strong>) refers to nodular scarring of the <a href="/articles/uterine-tube">fallopian tubes</a>. In very early stages, the tubes may appear almost normal. As scarring and nodularity progresses, the changes become more radiographically apparent.</p><h4>Pathology</h4><h5>Aetiology</h5><ul>- +<p><strong>Salpingitis isthmica nodosa (SIN)</strong>, sometimes also referred to as <strong>perisalpingitis isthmica nodosa - PIN</strong>, refers to nodular scarring of the <a href="/articles/uterine-tube">fallopian tubes</a>. In very early stages, the tubes may appear almost normal. As scarring and nodularity progress, the changes become more radiographically apparent.</p><h4>Pathology</h4><h5>Aetiology</h5><ul>
-<li>the prevailing theories include an inflammatory (<a href="/articles/salpingitis">salpingitis</a>), a congenital, and more recently an acquired (but not post-inflammatory) aetiology</li>-</ul><h5>Location</h5><p>It can involve the entire fallopian tube, but usually involves the proximal two-thirds of the fallopian tube.</p><h4>Radiographic features</h4><p>An accurate radiographic diagnosis is important due to its strong association with infertility and <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>.</p><h5>Hysterosalpingography (HSG)</h5><p>A characteristic finding is multiple nodular diverticular spaces involving the fallopian tubes (usually involving the proximal two-thirds of the fallopian tubes).</p><p><a href="/articles/hysterosalpingogram">HSG</a> of the nodular area with severe SIN shows several pockets (diverticulae) containing the introduced contrast material <sup>5</sup>.</p><p>It is observed that no dominant channel is seen as the contrast flows through the tube. This means there appears to be no direct pathway for sperm to travel which increases the chances of a tubal pregnancy.</p><h4>Treatment and prognosis</h4><h5>Complications</h5><ul>-<li>increased risk of <a href="/articles/tubal-ectopic-pregnancy">tubal ectopic pregnancy</a> <sup>4</sup>- +<li>the prevailing theories include an inflammatory (<a href="/articles/salpingitis">salpingitis</a>), a congenital, and more recently an acquired (but not post-inflammatory) aetiology</li>
- +</ul><h5>Location</h5><p>It can involve the entire fallopian tube, but usually involves the proximal two-thirds of the fallopian tube.</p><h4>Radiographic features</h4><p>An accurate radiographic diagnosis is important due to its high association with infertility and <a href="/articles/ectopic-pregnancy">ectopic pregnancy</a>.</p><h5>Hysterosalpingography (HSG)</h5><p>A characteristic finding is multiple nodular diverticular spaces involving the fallopian tubes, usually involving the proximal two-thirds of the fallopian tubes.</p><p><a href="/articles/hysterosalpingogram">HSG</a> of the nodular area with severe SIN shows several pockets (diverticula) containing the introduced contrast material <sup>5</sup>.</p><p>It is observed that no dominant channel is seen as the contrast flows through the tube. This means there appears to be no direct pathway for sperm to travel which increases the chances of a tubal pregnancy.</p><h4>Treatment and prognosis</h4><p>Treatment can be considered with recanalisation procedures either using a catheter guided by interventional radiology or by endoscopic surgery.</p><p>Complications:</p><ul>
- +<li>increased risk of <a href="/articles/tubal-ectopic-pregnancy">tubal ectopic pregnancy</a> <sup>4</sup>
-</ul><h4>History and etymology</h4><p>The term is derived from salpingitis for inflammation of the salpinx (tube), isthmica for involvement of the proximal isthmic portion of fallopian tube and nodosa for its nodular appearance.</p><h4>Differential diagnosis</h4><p>Considerations include:</p><ul><li>-<a href="/articles/tubal-tuberculosis">tubal tuberculosis</a> <sup>6 </sup><ul>-<li>often multiple constrictions can form along the course of the fallopian tube due to scarring, and give rise to a "beaded" appearance of the tubes on HSG</li>- +</ul><h4>History and etymology</h4><p>The term is derived from salpingitis for inflammation of the salpinx (tube), isthmica for the involvement of the proximal isthmic portion of fallopian tube and nodosa for its nodular appearance.</p><h4>Differential diagnosis</h4><p>Considerations include:</p><ul>
- +<li>
- +<a href="/articles/tubal-tuberculosis">tubal tuberculosis</a> <sup>6 </sup><ul>
- +<li>often multiple constrictions can form along the course of the fallopian tube due to scarring, and give rise to a "beaded" appearance of the tubes on HSG</li>
-</li></ul>- +</li>
- +<li><a href="/articles/endometriosis">endometriosis</a></li>
- +<li>tubal adenomyosis</li>
- +</ul>
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