A tubo-ovarian abscess (TOA) is one of the complications of pelvic inflammatory disease (PID).
Patients typically present with fever, elevated WBC count, lower abodminal-pelvic pain, an adnexal mass(es) and / or vaginal discharge. Fever and leukocytosis may sometimes be absent.
Tubo-ovarian abscess are often polymicrobial with a preponderance of anaerobic organisms 9.
The clinical context is extremely important in radiological interpretation.
- plain film features are non specific
- may show evidence of a soft tissue density mass
- there may be an added adynamic ileus
This is the initial imaging modality of choice
- often shows complex retro-uretine / adnenal mass(es)
Can be helpful adjunct to ultrasound especially in determining the extent of disease 3.
- usually shows thick walled fluid density pelvic masses.
- a tubular configuration is more conclusive of a pyosalpinx.
Can be useful especially when sonography is inconclusive or non-diagnosticor if gas content is difficult to be differentiated from bowel gas 5.
Typically seen as thick walled fluid filled pelvic mass(es)12
- T1 - abscess contents typically hypo-intense
- T2 - abscess contents typically of heterogenous signal or hyper-intense
- rupture of abscess
Initial treatment can be with antibiotictherapy. Radiological guided drainage or surgery may be required patients resistant to antibiotic treatment. Drainage may be performed from a trans-vaginal, trans-gluteal, or trans-abdominal approach dependant on patient and operator preference 4.
Clinical features of infection is a key to aid diagnosis as a number of other pathologies can give similar appearances 1.
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Synonyms & Alternative Spellings
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|Tuboovarian abscess (TOA)||✗|