Presentation
Ten days' history of left lower abdominal pain with tenderness, fever, and elevated inflammatory markers in a diabetic patient.
Patient Data
Distended left fallopian tube with a thick enhancing wall. It shows fluid content of intermediate signal on T1, high signal on T2 with restricted diffusion, surrounding an ovarian cystic collection of the same signal intensity and enhancement with restricted diffusion.
Surrounding inflammatory changes of the mesenteric fat with thickening and enhancement of the peritoneal reflections.
Uterine leiomyoma (FIGO 5).
Reactive left pelvic lymphadenopathy.
Case Discussion
The clinical presentation and the MRI features are highly suggestive of tubo-ovarian abscess, which was confirmed at surgery.
Risk factors for tubo-ovarian abscess include:
previous pelvic inflammatory disease
multiple sexual partners
history of uterine surgery
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