Current trends in the diagnosis and treatment of tuboovarian abscess
Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.
- Research Organization:
- Univ. of California, San Francisco
- OSTI ID:
- 5482078
- Journal Information:
- Am. J. Obstet. Gynecol.; (United States), Vol. 151:8
- Country of Publication:
- United States
- Language:
- English
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BACTERIAL DISEASES
DIAGNOSIS
OVARIES
ABSCESSES
COMPUTERIZED TOMOGRAPHY
FERTILITY
FORECASTING
PATIENTS
ULTRASONOGRAPHY
BODY
DIAGNOSTIC TECHNIQUES
DISEASES
FEMALE GENITALS
GONADS
INFECTIOUS DISEASES
ORGANS
PATHOLOGICAL CHANGES
TOMOGRAPHY
550602* - Medicine- External Radiation in Diagnostics- (1980-)