What Causes Fallopian Tube Stones?

Salpingoliths—stones that form within the fallopian tubes—are exceedingly rare clinical entities. Unlike more common urolithiasis or gallstones, salpingoliths do not arise from typical lithogenic pathways such as urinary stasis, bile supersaturation, or metabolic disorders. Instead, their formation is almost always secondary to chronic tubal inflammation, most frequently resulting from pelvic inflammatory disease (PID), often caused by *Chlamydia trachomatis* or *Neisseria gonorrhoeae*. Inflammatory damage leads to epithelial denudation, fibrosis, and luminal narrowing; debris—including desquamated cells, fibrin, and calcium salts—may accumulate in stagnant pockets and undergo dystrophic calcification over time.

Other potential contributors include prior tubal surgery, endometriosis-associated adhesions causing localized obstruction, or retained intrauterine devices (IUDs) with subsequent encrustation. In some cases, salpingoliths may represent calcified remnants of a resolved tubal pregnancy or granulomatous inflammation—such as that seen in tuberculosis or sarcoidosis—though these are exceptionally uncommon in high-resource settings.

Clinically, salpingoliths are typically asymptomatic and discovered incidentally on imaging—most often during pelvic ultrasound, CT, or hysterosalpingography. When symptomatic, presentations may mimic chronic pelvic pain, recurrent lower abdominal discomfort, or infertility due to mechanical tubal occlusion. Diagnosis requires correlation of radiographic findings (e.g., dense, laminated, intraluminal calcifications following the course of the fallopian tube) with clinical history and exclusion of mimics such as calcified lymph nodes, phleboliths, or uterine myomas.

Management is conservative unless complications arise. Asymptomatic salpingoliths require no intervention. Symptomatic or obstructive cases may warrant laparoscopic salpingectomy or salpingostomy—particularly if fertility preservation is desired and tubal patency can be restored. Antibiotic therapy is indicated only if active infection is confirmed; prophylactic antibiotics are not recommended for incidental findings.