emDocs - August 12, 2015 - By Al-Joburi D / Edited by Koyfman A and Alerhand S
"Tubo-ovarian abscess is an inflammatory mass involving the fallopian tube, ovary, or adjacent pelvic organs. When there is an agglutination of these structures, it is called a tubo-ovarian complex.1 While TOA was once more commonly associated with being life-threatening, advancements in antibiotics and surgical techniques have resulted in a near absent mortality.1However, failure to recognize it can result in irreversible tubal and ovarian damage, chronic pelvic pain, adhesion formation, ectopic pregnancy, and abscess rupture.
Summary
- Failure to recognize TOA can result in irreversible tubal and ovarian damage
- TOA can be seen in the pregnant, sexually inactive, and post-menopausal patient
- Be on alert for malignancy in the post-menopausal patient
- Think beyond PID as a sole risk factor: look for a history of infertility treatments and pelvic surgery
- Clinical presentations vary
- If ultrasound read doesn’t match the clinical scenario, get further imaging
- Admit all patients to monitor for response to antibiotics"
http://www.emdocs.net/tubo-ovarian-abscess-pearls-pitfalls/