Tubo-ovarian abscess is a pus-filled lump in the ovary or fallopian tube caused by an infection that travels up the reproductive tract. It is associated with pelvic inflammatory disease and sexual activity, and symptoms include lower abdominal pain, fever, and discomfort when urinating or passing stool. Diagnosis is important to distinguish it from other masses, and treatment involves antibiotics and surgical drainage if necessary.
A tubo-ovarian abscess is a pus-filled infected lump located in the ovary or fallopian tube. It is commonly caused by an infection that travels up the reproductive tract from the vagina and is typically part of what is known as pelvic inflammatory disease, in which bacteria multiply inside the pelvic cavity affecting structures such as the uterus and ovaries. Occasionally this disease may be the result of an infection spreading from nearby organs, in a disease such as appendicitis, but more often it is associated with sexual activity. A tubo-ovarian abscess usually appears in the later stages of PID, and although the disease can be life-threatening if left untreated, it usually responds to antibiotics, with surgery if necessary.
Most often, a tubo-ovarian abscess occurs in sexually active young women. An increased risk is also present in women who have had an intrauterine contraceptive device or IUD fitted. There are a number of different organisms that can be involved in the infection, with common examples being the bacteria that cause chlamydia and gonorrhea.
Symptoms that may occur due to this type of abscess may include lower abdominal pain and fever. Unusual bleeding or discharge from the vagina is sometimes observed, and there may be discomfort when urinating or passing stool. The areas around the reproductive organs may feel tender when examined by a doctor. Occasionally there are no symptoms and tubo-ovarian abscess can be found by chance on an ultrasound.
Diagnosing a tubo-ovarian abscess is important to distinguish it from other masses such as tumors and cysts. Ultrasound is typically used, but MRI or MRI scans may be helpful if the ultrasound results are unclear. The abscess typically appears on an ultrasound as a lump that has thick walls and is filled with fluid and debris.
As with other types of pelvic abscess, treatment for a tubo-ovarian abscess involves a hospital stay while antibiotics are given intravenously. If the abscess does not respond to antibiotic treatment, or if it is extremely large, it may need to be surgically drained. This can be done with a needle, using ultrasound images to guide the surgeon into the correct position, or the abscess may need to be cut. Occasionally it may be necessary to treat a fallopian tube abscess or an ovarian abscess by removing all of the affected tube or ovary.
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