Presentation
Five days lower abdominal pain with anorexia, nausea, and constipation.
Patient Data
A normal appearing anteverted, anteflexed uterus is present. Endometrial stripe measures 4 mm. Both ovaries are identified. The left ovary has a normal appearance.
The right adnexa contains a complex, predominantly cystic mass which has an US appearance most in keeping with a tubo-ovarian abscess.
An irregularly multiloculated, predominately fluid density mass in the right adnexa displaces the uterus to the left and posteriorly extends superior to the uterus to impinge upon the sigmoid colon at the apex of a very acute sacrococcygeal angle.
There appears to be associated free fluid in the pouch of Douglas.
Conclusion
The insinuation of the complex mass into anatomical spaces is in keeping with the diagnosis of tubo-ovarian abscess.
Case Discussion
Tubo-ovarian abscesses are a long-term complication of pelvic inflammatory disease.
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