Tubo-ovarian abscess

Case contributed by Dr Mostafa El-Feky

Presentation

Pelvic pain and tenderness

Patient Data

Age: 55 years
Gender: Female
MRI

Pelvis

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.

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Case information

rID: 75067
Published: 20th Mar 2020
Last edited: 27th Dec 2020
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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