CT pelvis with contrast
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Bilateral adnexal tortuous tubular lesions. The left sided lesions is seen collectively measuring 9 x 5 cm with, the right side averages 5 x 5 cm. They show marginal enhancement with fluid density content and marked surrounding fat stranding. They are seen inseparable from the uterus which is showing heterogeneous enhancement. No evidence of soft tissue nodules.
Mild free ascites and few locoregional enhancing lymph nodes are seen.
Tubo-ovarian abscess is a late complication of pelvic inflammatory disease (PID). The ovaries couldn't be distinguished separately from the Fallopian tubes with wall enhancement of the dilated tubular structures. It is important to differentiate it from other causes of pelvic abscess like appendiceal abscess and diverticular abscess.