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Infectious Diseases in Obstetrics and Gynecology
Volume 6 (1998), Issue 3, Pages 138-140
http://dx.doi.org/10.1155/S106474499800026X
Gynecological Case Report

Bilateral Tubo-Ovarian Abscesses Four Years After Total Abdominal Hysterectomy

Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, and the Winship Cancer Center, Emory University School of Medicine, 1639 Pierce Drive, Atlanta 30322, GA, USA

Received 22 January 1998; Accepted 24 April 1998

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.