The symptoms of excess intestinal gas are different for each person. It acts as a physical barrier, preventing loss of water from the body, and preventing entry of substances and organisms into the body. That means it consists of layers of. This is the American ICD-10-CM version of N80. Adnexa Smooth muscle Nerves Vessels: small arteries, arterioles and lymphatics Small arteries, arterioles, venules, lymphatics and nerves conform a network of 2 connected plexuses parallel to the surface Superficial plexus: located in the upper reticular dermis, supplies the papillary dermis with a capillary loop system. " Now the question is did he just remove the. The 2024 edition of ICD-10-CM N70. Molluscum contagiosum presents as small, painless papules 1-3 mm in size with a central depression. This is the American ICD-10-CM version of H57. an extrauterine mass may not. The tip of the middle finger should be well lubricated and placed against the anal orifice. A 72-year-old female asked: Hysterectomy & bilateral ovaries removed 17 yrs ago. H55-H57 Other disorders of eye and adnexa. Short description: Oth postproc comp and disorders of eye and adnexa, NEC The 2024 edition of ICD-10-CM H59. 1016/s1701-2163 (16)34687-4. The ovary is supported by multiple structures in the pelvis. 0):. 89 became effective on October 1, 2023. It typically arises as a painless lesion in young African American or Hispanic males. 89 to ICD-9-CM. 9 - other international versions of ICD-10 D27. The. 9 may differ. fat stranding in the adnexa . A transverse view of the right adnexa did not demonstrate a definitive mass in the right adnexa. 292 - other international versions of ICD-10 N83. The principal goals of the evaluation of an adnexal mass are to determine whether the mass. H35. Pelvic ultrasonography to visualize the adnexa and the uterus is commonly performed in symptomatic and asymptomatic women of reproductive and menopausal age. 311 Postprocedural hemorrhage and hematoma of right eye and adnexa following an ophthalmic procedure H59. An appendix is considered an _____, or accessory organ. Gender: Female. The adnexa (tubes and ovaries) are neither tender nor enlarged. Although these tumors sometimes. A lack of contrast enhancement may be seen. General imaging differential considerations include. Define Bartholin Glands. Terminology is extremely important in the Eye and Ocular Adnexa (65091-68899) subsection. INTRODUCTION. Methods This was a single oncology centre, retrospective diagnostic accuracy. HU >50 on non-contrast CT suggests hemorrhagic necrosis 2. 9 to ICD-9-CM. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Learn how we can help. An adnexal mass (ie, solid or cystic mass of the ovary, fallopian tube, or surrounding connective tissues) is a common gynecologic issue. The initial detection and evaluation of an adnexal mass requires a. Andexxa (andexanet alfa) also helps raise levels of thrombin, an enzyme. 0): 742 Uterine and adnexa procedures for non-malignancy with cc/mcc; 743 Uterine and adnexa procedures for non-malignancy without cc/mcc; 760 Menstrual and other female reproductive system disorders with cc/mcc The ADNEX (Assessment of Different NEoplasias in the adneXa) model is a risk model developed by the IOTA (International Ovarian Tumor Analysis) group to differentiate benign and malignant neoplasms of the ovary and, among them, four different subgroups (borderline, stage I cancer, stage II-IV cancer, and secondary metastatic cancer). 82 may differ. 8 : H00-H59. 89 may differ. 9 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. , adnexa) of the eye, defined as the lacrimal apparatus, the extraocular muscles and the eyelids, eyelashes, eyebrows and the conjunctiva. With the aid of hand-held lenses, the examiner can view the posterior segment. Impaired tubal patency accounts for up to 35% of cases of subfertility and infertility. by turning the. The 2024 edition of ICD-10-CM D27. ANDEXXA acts as a factor Xa (FXa) decoy that 1,2: Binds directly to the free-floating factor Xa (FXa) inhibitors rivaroxaban and apixaban with high affinity1,2. What the results of this study add?Code 67113 is used for the repair of a giant tear of the retina, with vitrectomy, and endolaser photocoagulation. 2024 ICD-10-CM Range N00-N99. broad ligaments. Define Adnexa. Adnexa is a term used to include (1) pilosebaceous units, (2) modified sebaceous glands, (3) eccrine and apocrine sweat glands, and (4) nails. depression. 8 - other international versions of ICD-10 N93. Hyperechoic. Tumours of the cutaneous adnexa are lesions that arise from, or differentiate towards, structures in normal skin such as regions of hair follicles, sweat ducts/glands, sebaceous glands, or a combination of these elements. This is the American ICD-10-CM version of N93. They usually form in the ovaries, which make eggs and hormones, or the fallopian tubes, which connect. impression: normal ovaries/adnexa; recommendation: no follow-up >3 to ≤5 cm: report presence of simple cyst(s) and largest cyst diameter. Sectioning of a fibroma typically reveals a chalky-white surface that has a. 379 - other international versions of ICD-10 H35. A lower incidence in females is most likely due to the interposition of the uterus and adnexa between the bladder and the colon. This is what is called the adnexa region and includes the fallopian tubes, ovaries, uterus, and the connecting tissues. This activity will highlight the mechanism of. This is the American ICD-10-CM version of R19. The ocular adnexa refers to tissues and structures surrounding the eye, such as conjunctiva, the lacrimal gland, the eyelids, and the surrounding orbital soft tissue. Pelvic venous congestion syndrome is also known as ovarian vein reflux. A: Coronal (COR RO) and ( B) sagittal (SAG RO) images of the right ovary demonstrating a simple ovarian cyst ( arrows ). 379 became effective on October 1, 2023. A small size of a uterus compared to the adnexa. Severe disease: Apply a 1. In order to effectively perform a hysterectomy, the surgeon should have… Pelvic ultrasound is the imaging modality of choice to evaluate the uterus, cervix, ovaries, and adnexa. irritable. However, in certain conditions, this test may be appropriate more frequently. 0. 1 A reliable diagnostic test is needed, especially. 7%) and only one woman required adnexectomy. twisted pedicle in the adnexa. Other specified disorders of eye and adnexa. The posterior cul-de-sac is between the uterus and the rectum. If the mass presents with features clearly associated with benign pathology, the patient can be observed and re-evaluated after a period of time. After completion of the hysterectomy and ligation of the RFUO complex, a long and moist vaginal pack (I prefer the 4" x 36" cotton vaginal pack by Dukal) is used to push the bowels back and expose the adnexae. 1). This is the American ICD-10-CM version of N83. 9 became effective on October 1, 2023. Women who present with colovesical fistulae are usually older or have a history of hysterectomy. 133 became effective on October 1, 2023. The 2024 edition of ICD-10-CM R10. 1 Early ovarian cancer is often asymptomatic, and most women have advanced disease at presentation. Anteflexed: Body is flexed normally anteriorly on the cervix (270 degrees). The ovaries are suspended laterally to the uterus via the utero-ovarian. On rare occasions, transient distention of the fallopian tubes occurs because of retrograde passage of blood from the uterus without complete. An adnexal mass is an abnormal growth that develops near the uterus, usually in the ovaries, fallopian tubes, or surrounding connective tissues. Several general guidelines are repeated inAdnexa appear to be particularly prone to torsion in the early pubertal years. The lesion is resected by laparoscopy. Ultrasonography (US) is typically the first study to be requested in patients with clinical findings that may suggest pelvic disease. An adnexal (ad-nek-suhl)mass is a growth that develops around the uterus, usually in your ovaries, fallopian tubes and neighboring connective tissues. Meaning of adnexa. swelling of the vagina or vulva. Both the ovary and the fallopian tube typically are involved; hence, the preferred term adnexal torsion rather than ovarian torsion . Ocular adnexal lymphomas predominantly affect older individuals, with a median age in the 60s, and with. Strangulated adnexa due to an adhesive band in a 50-year-old woman (A). 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 810 to ICD-9-CM. ICD-10-CM Official Guidelines for Coding and Reporting FY 2023 -- UPDATED April 1, 2023 (October 1, 2022 - September 30, 2023) Narrative changes appear in bold textThe tumor belongs to the same histopathologic spectrum as an ovarian thecoma / ovarian fibrothecoma. As per American College of Radiology (ACR) guidelines, the required elements for 76801 are “appropriate for gestation” and “visible. Here we will provide a overview of ocular embryology, covering the key stages and events involved in the. 760 Menstrual and other female reproductive system disorders with cc/mcc. may show multiple dilated veins in the adnexa with reversed venous flow on color Doppler, especially after Valsalva maneuver. 2 may differ. 1 may differ. Head and neck:Pelvic congestion syndrome (PCS) is one of the pelvic venous syndromes that is frequently misdiagnosed. It augments transabdominal ultrasound for a more complete evaluation of the ovaries, adnexa, uterus, cervix, and surrounding pelvic regions. It is often used by radiologists when referring to lesions near the uterus in the. Andexanet alfa is sold in 100-mg and 200-mg vials; the 100-mg AWP is $3,300 and the 200-mg AWP, $6,600. This is the American ICD-10-CM version of H53. Uterus and fallopian tubes D. When a hydrosalpinx. hair. 8 - other international versions of ICD-10 H53. Unspecified disorder of eye and adnexa. add. Chronic pelvic pain is pain in the lower abdomen which has been. 2 became effective on October 1, 2023. Lorenzen Introduction. 819. The ovary is supported by multiple structures in the pelvis. The condition is thought to be due to problems with the enlarged veins in your pelvic area. cystic ovarian neoplasm(s): identification of a separate ovary helps distinguish a hydrosalpinx from a cystic ovarian mass, an important distinction because. The nodules are classically described as yellow-white, mobile and firm. Fig 2 – The bimanual examination. - a. 742 Uterine and adnexa procedures for non-malignancy with cc/mcc; 743 Uterine and adnexa procedures for non-malignancy without cc/mcc; 760 Menstrual and other female reproductive system disorders with cc/mcc; 761 Menstrual and other female reproductive system disorders without cc/mcc; Convert N83. This is the American ICD-10-CM version of C54. The development of the eye is a marvel of complexity, involving a series of intricate cascading cellular events, precisely choreographed by a set of molecular signals that switch on and off genetic programs. This is the American ICD-10-CM version of H35. FIGURE 1. Severe disease: Up to 2 drops into the affected eye (s. RESULTS. #3. The patient came back 3 days later with recurrent right lower quadrant pain. 09 may differ. Adnexa foreign body management in the fornix was challenging because of the narrowing of the operating space. do not call an anechoic ovarian structure a "cyst" in a premenopausal woman unless it is >30 mmPalpate adnexa via bimanual exam. OBJECTIVE. Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. 54 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The following code (s) above H57. Pelvic pain is the main symptom. Treatment and prognosis. The most common types of adnexal masses in pregnancy requiring surgical management are dermoid cysts (32%), endometriomas (15%), functional cysts (12%),. Ovarian torsion is a process that occurs when the ovary twists over the ligaments that support it in the adnexa. These include the fallopian tubes, ovaries, and. If conservative surgery is felt to be appropriate in women. C54. e. Adnexal torsion may involve the fallopian tubes, ovaries or both. Rapidly reduces free plasma concentration of the factor Xa (FXa) inhibitors rivaroxaban and apixaban, which neutralizes their anticoagulant. You should individualize your exam for the specific patient. Disorders including pelvic inflammatory disease (hydrosalpinx and. 379 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Anticoagulation reversal is often a critical need when therapy does not work as planned and bleeding ensues. Best answers. 79 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Sequesters factor Xa (FXa) inhibitors 1. Classically, a TOA manifests with an adnexal mass, fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge; however, presentations of this disease can be highly variable. The accessory visual structures (or adnexa of eye, ocular adnexa, etc. 1. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Adnexa is a Latin word meaning attachment or appendages. 8 became effective on October 1, 2023. 3 contain annotation back-references that may be applicable to N80. Torsion of the normal adnexa is a challenging entity to diagnose. USG has been a trusted modality for imaging the adnexa and associated pathologies such as torsion. See examples of ADNEXA used in a sentence. 8 ng/ml. This Latin word (in the plural) is used in medicine in reference to appendages. Hematogeneous spread of microorganisms may be due to bacterial invasion into the portal system via colonic mucosal defects . Adnexal cysts are a common incidental finding at US, CT, and MRI but have historically caused a diagnostic dilemma for determining when to follow up and how to manage them. An adnexal mass is a growth that occurs in or near the uterus, ovaries, fallopian tubes, and the connecting tissues. Other visual disturbances. However, due to the possible complications involving benign adnexal cysts (ie, adnexal torsion, pelvic pain) and the utmost importance of early diagnosis and treatment. 2024 ICD-10-CM Codes. In the postmenopausal patient, it is performed for a variety of reasons, but most often for the evaluation of postmenopausal bleeding or an adnexal mass. The 2024 edition of ICD-10-CM N83. by turning the. Accessory organs of the uterus (ovaries and fallopian tubes) Define Amenorrhea. Beachbum32459 said: According to the 2018 OB/GYN coding companion CPT code 58661 is the laparoscopic removal of ADNEXAL STRUCTURES ie: ovary and or fallopian tubes (partial or total). ADNEXA definition: adjoining organs, esp of the uterus | Meaning, pronunciation, translations and examples National Center for Biotechnology Information Bookshelf ID: NBK470360 PMID: 29262064. Surgery: Endocrine, Nervous, Eye and Ocular Adnexa, and Auditory Systems CPT Codes 60000 – 69999 . 1. Z codes represent reasons for encounters. These factors include the offending agent, length of exposure, the surface area affected, and which ocular tissues are involved. The adnexa were small and atrophic. The appendages or accessory structures of an organ. Endometriosis is a common, chronic gynecological condition defined as the presence of functional endometrial glands and stroma-like lesions outside the uterus. This includes the ovaries, the fallopian tube and the supporting struct. 991. A hydrosalpinx results from an accumulation of secretions when the tube is occluded at its distal end (obstruction of the ampullary segment) or both ends. 9 became effective on October 1, 2023. Accessory or adjoining anatomical parts, as ovaries and fallopian tubes in relation to the uterus. As per American College of Radiology (ACR) guidelines, the required elements for 76801 are “appropriate for gestation” and “visible. opercular series +. osseus cochlea +. The 2024 edition of ICD-10-CM Z90. Female pelvic masses have a broad differential diagnosis, including benign and malignant neoplasms and nonneoplastic entities. Corpus luteum cysts. Adnexal tumors are growths near the uterus. The 2024 edition of ICD-10-CM N73. a dominant follicle in the ovaries reaches 20-25 mm diameter at maturity. A hydrosalpinx is a specific type of fallopian tube blockage. Pelvic ultrasonography to visualize the adnexa and the uterus is commonly performed in symptomatic and asymptomatic women of reproductive and menopausal age. A patient has ovarian cancer of both ovaries. Adnexal tenderness occurs when there is pain or general tenderness. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. A. The appendages to the uterus are collectively known as the adnexa uteri. How to use adnexa in a sentence. 89 became effective on October 1, 2023. excision of lesions of the ovary. 292 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The most common pathogen that invades a preexisting. adnexa: [plural noun] conjoined, subordinate, or associated anatomical parts. Most ovarian cysts require no treatment. The ADNEX (Assessment of Different NEoplasias in the adneXa) model is a risk model developed by the IOTA (International Ovarian Tumor Analysis) group to differentiate benign and malignant neoplasms of the ovary and, among them, four different subgroups (borderline, stage I cancer, stage II-IV cancer, and secondary metastatic. This indication is approved under accelerated approval based. This chapter will primarily focus on non. Here is the first important point to identify the running of ureter to prevent the ureteral injury. The color score increases with the amount of color flow seen, up to a color score of 4 (very strong blood flow), which can indicate a malignant or M-feature. Some texts also include the associated blood vessels, nerves and other supporting tissues in the definition. 03 became effective on October 1, 2023. A small size of a uterus compared to the adnexa. doi: 10. + + Introduction. prolonged menstrual bleeding. In clinical trials, andexanet alfa decreased anti-FXa activity by 94% and 92% in patients on apixaban and rivaroxaban. They are discussed separately. They are discussed separately according to anatomic location: intracranial dermoid cyst. uterus displaced to the involved side. 79 became effective on October 1, 2023. Oct 7, 2010. The adnexa, or more formally the adnexa uteri, and also known as the uterine appendages, is a collective term for the: ovaries. Occasionally, special examinations may be required to identify specific ocular disorders or to establish the presence of associated systemic disease. " The adnexa of the uterus include the ovaries, fallopian tubes, and structures of the broad ligament. This is the American ICD-10-CM version of R10. Adnexa have been described in relation to: cutaneous/skin adnexa. There is no one reason adnexal torsion happens. This is the American ICD-10-CM version of N80. This activity reviews pelvic ultrasound in the postmenopausal patient and highlights. Characteristic imaging features of simple adnexal cysts include a simple fluid collection with smooth walls and no solid or vascular components. Many of the lesions that involve the adnexa are similar to those seen in other areas of the body and general surgical pathologists may feel that there is. Study with Quizlet and memorize flashcards containing terms like CASE 6 OB DELIVERY NOTE Indications: 31 y/o G3P1 at 39 and 4/7 weeks admitted in labor. Adnexal torsion: Excessive rotation of the infundibulo-pelvic ligament around its axis with impairment of flow through the ovarian artery and vein that supply the ovary and fallopian tube ( Figure 24-1 ). Adnexal tumors are growths near the uterus. In one retrospective study, torsion recurred in 7 of 11 patients (64 percent; mean age 25 years) with normal adnexa compared with 4 of 46 patients (9 percent; mean age 31 years) with abnormal adnexa; all patients with recurrent torsion had the same diagnosis (torsion with a normal versus abnormal ovary) for the first and second torsion. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 3 : N00-N99. We studied 174 patients with ocular adnexal lymphoma (OAL) to evaluate long-term clinical outcome and patterns of failure. Abnormal morphology of the ocular adnexa. The lesion is resected by laparoscopy. 1 became effective on October 1, 2023. A general care pathway for adnexal masses discovered in a family medicine setting. A corresponding procedure code must accompany a Z code if a procedure is performed. Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. what next?In closing, PGAs induce several modifications of ocular surface and adnexa, that can be recognized in vivo and in vitro, but none reduces the overall safety profile of this class of drugs. They have several possible causes, which can be gynecological or. Normal adnexa without a mass can twist (torse). 89 may differ. All neoplasms are classified in this chapter, whether they are functionally active or not. At the time of the study, nonspecific echogenicity in the right adnexa was interpreted as bowel loops. Medical Definition of Adnexa. 2 became effective on October 1, 2023. Hydrosalpinx is a condition in which a fallopian tube becomes blocked with fluid due to either illness or injury. The examination and evaluation of persistent adnexal masses are based on the IOTA guidelines and are discussed in Chaps. Gently move the cervix from side to side to check for cervical tenderness (important sign with ectopic pregnancy or pelvic inflammatory disease). Simple ovarian cyst. This chapter includes symptoms, signs, abnormal. It has an important function during pregnancy. Torsion of the adnexa is a gynecologic emergency that affects approximately 2%–3% of females who present with acute pelvic pain (2–4). amblyopia . The overall incidence of ovarian cancer is relatively low, accounting for just over 1% of all cancer diagnosis in 2021. A00-B99 Certain infectious and parasitic diseases. This is the American ICD-10-CM version of Z98. Transvaginal ultrasound shows a multicystic lesion involving the cul de sac, left uterine adnexa and rectal serosa. 89 to ICD-9-CM. 9 may differ. A patient has ovarian cancer of both ovaries. Given the focus of ultrasound on the uterus and. [1] Others include the supporting tissues". 89 may differ. Cyst of the uterine adnexa; Cyst of uterine adnexa; Fallopian tube cyst; Left broad ligament cyst; Left fallopian tube cyst; Right broad ligament cyst; Right fallopian tube cyst; ICD-10-CM N83. Reuter and M. Lack of irradiation is important since the ovary is particularly sensitive to. The fallopian tube often twists with the ovary and is then referred to as adnexal torsion. Generally speaking, surgery isn’t recommended for ovarian cysts unless they’re larger than 50 to 60 millimeters (mm) (about 2 to 2. N83. A. , adnexa) of the eye, defined as the lacrimal apparatus, the extraocular muscles and the eyelids, eyelashes, eyebrows and the conjunctiva. Simple ovarian cyst. Adnexal torsion: Excessive rotation of the infundibulo-pelvic. scar ectopic: site of previous cesarean section scar; rare. This is the American ICD-10-CM version of H35. Adnexal tenderness is a technical term for pain in the area of a woman’s uterus. Adnexa Including Ovaries and Fallopian Tubes When evaluating the adnexa, an attempt should be made to identify the ovaries first because they can serve as a major point of reference for assessing the presence of adnexal pathology. FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019. In terms of the absolute number of deaths, it ranks second among gynecologic cancers following breast cancer. [1][2] Complete surgical excision with histopathologic examination is diagnostic as. Many tumors may be classified by using the IOTA Simple Rules model. 9 is applicable to female patients. A hydrosalpinx rarely causes symptoms. Adnexal masses are frequently found in both symptomatic and asymptomatic women. Most frequently, adnexal masses refer to ovarian masses or cysts ; however, paratubal cysts, hydrosalpinx, and other nonovarian masses are also included. 3 - other international versions of ICD-10 N80. 1: Division of the round ligaments (left and right) 1. The term adnexa includes the fallopian tubes, the ovaries, and their ligamentous attachments in the female pelvis. A lack of contrast enhancement may be seen. Researchers aren’t sure what causes PCS, but it’s likely that changes to your veins during pregnancy and estrogen play. Surgery. D27. Best answers. [2] Uterine appendages. The term adnexa is derived from the pleural form of the Latin word meaning "appendage. Code HistoryAcute ocular burns may constitute an ophthalmic emergency. The adnexa of the uterus is the collective term for the appendages attached to the uterus, such as ovaries, fallopian tubes, and round ligaments. 722 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Approximately 8% of all extranodal lymphomas arise in the ocular adnexa . 209 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Abscess secondary to diverticulitis may also occur at distant sites such as liver, adnexa, lung and rare localizations such as brain and spine. , systemic chemotherapy, X-ray therapy more extensive than to the area of the eye, or surgery more extensive than. 2. It varied from 1/76 to 1/2328 deliveries in a recent study [ 5 ]. parous: maximum volume of 15 mL. All lymphomas presenting with involvement of the ocular. This is the American ICD-10-CM version of H57. 90 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 379. minimal free fluid . ICD-10-CM N83. MRI was performed on a 1. Detailed information regarding follow-up of ocular adnexal lymphoma and of the frequency of large cell transformation of low-grade ocular adnexal lymphoma is limited. The model. Uterus and right broad ligament, seen from behind. Additionally, a serine to alanine (S419A) mutation in the. Surgical Procedures on the Eye and Ocular Adnexa. Complete procidentia with cystocele and rectocele. 8 is applicable to female patients. 9 - other international versions of ICD-10 N80. Adnexa (single/plural) is a general term that refers to the accessory structures of an organ. It is a common cause of chronic pelvic pain in women of reproductive age. Methods A retrospective study was conducted at a tertiary center. H57. elongated paraovarian cyst. Most adnexal tumors are benign (noncancerous), but some are malignant (cancerous). Code HistoryColovesical fistulae are more common in males. Familiarity with and recognition of the characteristic imaging features of these diseases and conditions are imperative for accurate diagnosis and prompt patient management. Hydrosalpinx is a common adnexal lesion that may occur either in isolation or as a component of a complex pathologic process (eg, pelvic inflammatory disease, endometriosis, fallopian tube tumor, or tubal pregnancy) that leads to distal tubal occlusion.