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A tubo-ovarian abscess (TOA) is one of the late complications of pelvic inflammatory disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis. It consists of an encapsulated or confined pocket of pus with defined boundaries that forms during an infection of a fallopian tube and ovary .
During an infertility work-up a hysterosalpingogram, an X-ray procedure that uses a contrast agent to image the fallopian tubes, shows the retort-like shape of the distended tubes and the absence of spillage of the dye into the peritoneum. If, however, there is a tubal occlusion at the utero-tubal junction, a hydrosalpinx may go undetected.
In premenopausal women, adnexal masses include ovarian cysts, ectopic (tubal) pregnancies, benign or malignant tumors, endometriomas, polycystic ovaries, and tubo-ovarian abscess. The most common causes for adnexal masses in premenopausal women include follicular cysts and corpus luteum cysts .
Laparoscopic identification is helpful in diagnosing tubal disease; a 65 percent to 90 percent positive predictive value exists in patients with presumed PID. [25] Upon gynecologic ultrasound, a potential finding is tubo-ovarian complex, which is edematous and dilated pelvic structures as evidenced by vague margins, but without abscess ...
A hematosalpinx from a tubal pregnancy may be associated with pelvic pain and uterine bleeding. A gynecologic ultrasound will show the hematosalpinx. A hematosalpinx from other conditions may be painless but could lead to uterine bleeding.
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
Device for both vaginal ultrasonography and abdominal ultrasonography Transvaginal ultrasonography to check the location of an intrauterine device (IUD). The examination can be performed by transabdominal ultrasonography, generally with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or by transvaginal ultrasonography with a specifically ...
On histopathology, paraovarian cysts are generally lined by simple cuboidal epithelium as shown. However, they may have fallopian tubal epithelium or focal papillary projections. [2] Most cysts are small and asymptomatic. [1] Typical sizes reported are 1 to 8 cm in diameter. [1]