Presentation
Right pelvic pain.
Patient Data
Right thick-walled tubo-ovarian abscess showing a low signal on T1 WI and high signal on T2 and STIR WI with diffusion restriction. Associated with surrounding inflammatory fat plane smudging.
A tubular structure (the appendix tip) is seen imbedded and inseparable from the aforementioned tubo-ovarian abscess.
Appendix is shown in the images (arrows).
Case Discussion
The patient mentioned she was not sexually active.
The patient was rushed to the operating room; she underwent appendectomy and drainage of the tubo-ovarian abscess.
TOA usually occurs as a complication of pelvic inflammatory disease (PID). However, less commonly, it might occur secondary to inflammatory bowel disease, bowel perforation, or a complication of perforated appendicitis, as presented here.
The proximity of the appendix to the fallopian tubes and the peristaltic nature of the appendix increases the risk of the tubo-ovarian abscess (TOA) following perforation of the appendix.