Bilateral Tubo-Ovarian Abscesses Four Years AfterTotal Abdominal Hysterectomy

[摘要] Background:Pelvic inflammatory disease (PID) is a common gynecologic disorder. One knowncomplication of PID is tubo-ovarian abscess (TOA) formation. The predominant theory on TOAformation postulates that an ascending infection from the cervix through the uterus to the fallopiantubes and ovaries results in abscess formation. Other theories include seeding via a hematogenousinfection, diverticular disease, and appendicitis.Case:A 39-year-old female patient with abdominal pain was referred to our institution and wasfound to have a pelvic mass. After a thorough evaluation, surgical exploration revealed the presenceof TOA. No evidence of gastrointestinal disease was present. The patient’s history was significantfor an uncomplicated total abdominal hysterectomy for benign disease of the uterus four yearsprior. Abscess cultures grewStreptococcus intermedius.Conclusion:This case reports the rare occurrence of TOA in a patient who had undergone anabdominal hysterectomy four years prior to presentation. If the patient reports a surgical history ofprior hysterectomy, TOA is often stricken from consideration. Although unlikely, adnexal abscessformation should be considered in the differential diagnosis of a patient with abdominal pain and apelvic mass, even with a remote history of hysterectomy.

[学科分类] 妇产科学