Reproductive system · Pelvis · Female
Ampulla of uterine tube !
The ampulla is the wide middle part of the uterine tube; it is where the egg is usually fertilised and the most common site of an ectopic pregnancy.
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What it is
The longest and widest part of the tube.
What it does
Where the egg is usually fertilised, and the most common place for an ectopic pregnancy.
Key facts
- Where
- Widest and longest part (about half the tube), between isthmus and infundibulum, with a highly folded mucosa
- Function
- Usual site of fertilisation and of about 70–80% of ectopic pregnancies
Relations
- Medial
- Isthmus of uterine tube
- Lateral
- Infundibulum and fimbriae
- Below
- Ovaries, over whose upper pole it arches, and the mesosalpinx
How to find it
At laparoscopy it is the widest and longest part of the tube, its wall thin and winding, curving over the ovary between the narrow isthmus and the fringed funnel; an unruptured ectopic is seen as a bluish swelling here.
On imaging
On transvaginal ultrasound a tubal ectopic appears as an adnexal mass separate from the ovary, often a bright ring around a small sac (tubal ring), with an empty uterine cavity and a positive hCG; free fluid or clot in the rectouterine pouch suggests rupture.
Common problems
- Ectopic pregnancy (a pregnancy that implants in the tube).
- Infection (pelvic inflammatory disease) that can scar and block the tubes and cause infertility.
How it is diagnosed
Ultrasound and a pregnancy hormone (hCG) test for ectopic pregnancy; tests of tubal patency for infertility.
Treatment
- Tubal ligation or removal of the tubes (salpingectomy) for permanent contraception.
- An ectopic pregnancy is treated with medicine (methotrexate) or surgery.
Clinical notes
- An ampullary ectopic is treated medically, by salpingostomy (opening the tube to remove the pregnancy) or by salpingectomy (removing the tube), depending on the case
- A hydrosalpinx distends mainly the ampulla, which balloons once the fimbrial end is sealed
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
What normally happens in the ampulla of the uterine tube, and what abnormal event is commonest there?
Fertilisation of the egg usually occurs there; it is also the commonest site of ectopic pregnancy.
Why does an ampullary ectopic pregnancy tend to rupture later than an isthmic one?
The ampulla is a wider, more stretchable segment of the uterine tube.
Why can a ruptured ampullary ectopic pregnancy cause shoulder-tip pain?
Blood collects in the rectouterine pouch and, reaching the diaphragm, refers pain to the shoulder tip.
What does a tubal ectopic look like on transvaginal ultrasound?
An adnexal mass separate from the ovary, often a bright tubal ring, with an empty uterine cavity and positive hCG.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ampulla tubae uterinae TA2 3491
- Official Spanish (DeCS)
- Ampolla de la trompa uterina
- English (TA2)
- Ampulla of uterine tube
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Fallopian Tube.
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Representative model, for educational purposes only.
