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previously visited TUBO-OVARIAN ABSCESS Random Case
Authored By: Janet Neutze, Radiologist, Penn State College of Medicine, Pennsylvania, USA.
Patient: 28 year 4 month old female
History:  
*
HPI: 28 year old female with epigastric and right sided abdominal pain and dizziness
*PMH: Ex-lap, appendectomy, left salpingo-oophorectomy
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Findings:  
*Physical Exam: T 37.7 HR 82 RR 18 BP 109/60
nGuarding, rebound tenderness in RLQ
nUterus and right adnexa tender
nRight pelvic mass palpated and nonmobile
*Labs: WBC 16.9, elevated ESR
DDx:  
*
ectopic pregnancy, pelvic neoplasm, ovarian hematoma or torsion, appendiceal or diverticular abscess
Diagnosis: Tubo-ovarian Abscess -->
*Large distended tubular structure in the right hemipelvis associated with right ovary
*11.5 cm in craniocaudal dimension by 6.7 x 7.6 cm transaxially
*Mass displaces the uterus to the left
Discussion:  *Causes: PID, pelvic surgery, bowel perforation (appendicitis, diverticulitis), pelvic malignancy
nTOA is most severe form of PID
*Common organisms: anaerobes (Bacteroides, Peptostreptococcus), Streptococcus species, E. coli, other gram negative enteric organisms
*Diagnosis: abdominal/pelvic pain, fever, leukocytosis
*Ultrasonography: one or more relatively homogeneous, somewhat symmetrical, cystic, thin-walled, well-demarcated masses which are usually contiguous; An air fluid level may be seen; septations are present in multiloculated TOAs
*Treatment: Transvaginal drainage with ultrasound guidance; broad spectrum antibiotics
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Additional Details:

Case Number: 18976884Last Updated: 09-12-2008
Rating:

6 ratings
Anatomy: Genitourinary (GU)   Pathology: Infection
Modality: CTAccess Level: Readable by all users
Keywords: tubo-ovarian, abscessContained in: Case of the Week, Featured Case Candidates, feilbert, ycchang6
Case has been viewed 2345 times.

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