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Author Notes:

Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, and the Winship Cancer Center, Emory University School of Medicine, Atlanta, GA

Emory University School of Medicine, Department of Gynecology and Obstetrics, 1639 Pierce Drive, Atlanta, GA. 30322

Subjects:

Keywords:

  • Abscess
  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Hysterectomy
  • Pelvic Inflammatory Disease
  • Streptococcal Infections

Bilateral tubo-ovarian abscesses four years after total abdominal hysterectomy.

Tools:

Journal Title:

Infectious Diseases in Obstetrics and Gynecology

Volume:

Volume 6, Number 3

Publisher:

, Pages 138-140

Type of Work:

Article | Final Publisher PDF

Abstract:

BACKGROUND: Pelvic inflammatory disease (PID) is a common gynecologic disorder. One known complication of PID is tubo-ovarian abscess (TOA) formation. The predominant theory on TOA formation postulates that an ascending infection from the cervix through the uterus to the fallopian tubes and ovaries results in abscess formation. Other theories include seeding via a hematogenous infection, diverticular disease, and appendicitis. CASE: A 39-year-old female patient with abdominal pain was referred to our institution and was found to have a pelvic mass. After a thorough evaluation, surgical exploration revealed the presence of TOA. No evidence of gastrointestinal disease was present. The patient's history was significant for an uncomplicated total abdominal hysterectomy for benign disease of the uterus four years prior. Abscess cultures grew Streptococcus intermedius. CONCLUSION: This case reports the rare occurrence of TOA in a patient who had undergone an abdominal hysterectomy four years prior to presentation. If the patient reports a surgical history of prior hysterectomy, TOA is often stricken from consideration. Although unlikely, adnexal abscess formation should be considered in the differential diagnosis of a patient with abdominal pain and a pelvic mass, even with a remote history of hysterectomy.

Copyright information:

© 1998 Wiley-Liss, Inc.

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