Tubo-ovarian abscess

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Pelvic pain and tenderness

Patient Data

Age: 55 years
Gender: Female

Pelvis

mri
This study is a stack
Sagittal
T2
This study is a stack
Axial
T2
This study is a stack
Axial
T1
This study is a stack
Axial T1
fat sat
This study is a stack
Coronal
T2
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Axial T1
Abdomen
Download
Info

A tubular/cystic right adnexal lesion is noted, measuring 8.5 x 10.5 cm, showing thick enhancing walls and non-enhancing fluid contents showing marked Diffusion restriction (suggesting purulent nature) with no solid components. Marked pelvic inflammatory fat stranding. 

Dilated right ureter (9 mm) mostly sequel to this abscess.

IUCD in place. 

Case Discussion

This case demonstrates features of pelvic inflammatory disease (PID) with right tubo-ovarian abscess with pyosalpinx and pelvic peritonitis. The ovaries couldn't be distinguished separately from the fallopian tubes.

A tubo-ovarian abscess is a late complication of pelvic inflammatory disease (PID). It is important to differentiate it from other causes of pelvic abscess like appendiceal abscess and diverticular abscess. MRI is the best choice if clinically suspecting a pelvic inflammatory mass.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.