Presentation
Pelvic pain.
Patient Data
Complex, enhancing collection centered in the left ovary, with elongated tubular structure along the medial aspect extending towards the left uterine cornua, indicating a dilated and thickened tube leading into an ovarian collection. The peripheral enhancing ovarian collection measures about 4 cm, with relative edema of the remainder of the ovarian parenchyma. The ovary can be confirmed by identifying the gonadal vessels. There is some presumed reactive inflammation of the right ovary but without defined or enhancing collections. Small amount of pelvic ascites. Uterus within normal limits with intrauterine device in expected position. Normal appendix.
Case Discussion
Left tubo-ovarian abscess, with clearly delineated enhancing, dilated left fallopian tube, leading into a left ovarian abscess. There is some reactive inflammation of the right ovary as well. This is an important mimic of acute appendicitis, and in this case the appendix can be confidently seen and is normal.
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