What are the causes of left adnexitis, and how is it treated?

Left adnexitis is an inflammatory condition affecting the left adnexa and represents a localized manifestation of pelvic inflammatory disease. It mainly includes two types: acute adnexitis and chronic adnexitis. The condition is thought to be associated with exogenous and endogenous pathogen infections. Symptoms can be alleviated through general management, medication, physical therapy, and other approaches under medical guidance.

1. Acute Adnexitis

Acute inflammation of the adnexa occurs when the natural defense mechanisms of the genital tract are compromised, immune function decreases, hormonal changes occur, or exogenous pathogens invade. Typical symptoms include lower abdominal pain and increased vaginal discharge; abdominal pain may worsen with physical activity or intercourse. Severe cases may present with high fever, chills, and headache. If the condition develops during menstruation, menstrual flow may increase and periods may be prolonged.

Bed rest is recommended, along with a diet of high-calorie, high-protein, high-vitamin liquid or semi-liquid foods, and adequate fluid intake. Physical cooling methods should be used for high fever, and gastrointestinal decompression may be performed in patients with abdominal distension. Oral medications such as metronidazole tablets, levofloxacin hydrochloride capsules, and minocycline hydrochloride capsules may be prescribed. For patients unable to tolerate oral medications, intravenous treatments such as amoxicillin sodium and sulbactam sodium for injection or gentamicin sulfate injection may be administered.

2. Chronic Adnexitis

Most patients have mild or nonspecific symptoms. The typical presentation is chronic pelvic pain accompanied by dull lower abdominal discomfort, which may worsen after fatigue, sexual intercourse, or menstruation. A minority of patients may have a history of menstrual irregularities, infertility, or ectopic pregnancy. Systemic symptoms are usually mild. Treatment for chronic pelvic pain includes medications such as ibuprofen sustained-release capsules, acetaminophen tablets, metronidazole tablets, and cefixime tablets, as directed by a physician. Physical therapies such as peripheral nerve stimulation or dorsal root ganglion stimulation may also help manage chronic pain.

If surgical intervention is indicated, procedures such as conservative surgery, percutaneous drainage under ultrasound or CT guidance, or transurethral incision for abscess drainage may be necessary.