Tubo-ovarain abscess in patient with ovarian endometriosis

Monika Gupta, Tripti Jain, Neha Goel, Sunita Singh
In: International Journal of Research in Medical Sciences · 2023 · vol. 11(2) , pp. 704–706 · doi:10.18203/2320-6012.ijrms20230190 · W4318035284
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This case report describes a tubo-ovarian abscess in a patient with endometriosis, highlighting the need for further studies into the potential link and causes of TOA in endometriosis patients.

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This case report describes a patient with ovarian endometriosis who developed a tubo-ovarian abscess following a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological analysis confirmed the presence of endometriosis alongside xanthogranulomatous salpingitis and oophoritis, despite the absence of typical risk factors such as chronic infection or intrauterine devices. The authors highlight this rare co-occurrence to raise awareness about potential complications in patients with endometriosis and call for further studies to determine the underlying causes. This paper is centrally about endometriosis — specifically investigating its association with tubo-ovarian abscess formation in a post-surgical context.

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Abstract

Tubo-ovarian abscess (TOA) is a sequela of pelvic inflammatory disease (PID) found in 15-34% of patients, is comprised of an infectious, inflammatory complex encompassing the fallopian tube and ovary. We are presenting a case of TOA with endometriosis in a patient who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological findings were compatible with endometriosis with xanthogranulomatous salpingitis and oophoritis. In our patient there was no history of any chronic infection, gynecological procedures or intra uterine device and single partner. The purpose of this case is to make aware of this condition and requirement of further studies to investigate the risk of TOA in patients with endometriosis to find out the exact cause to prevent unnecessary surgery at later stage.
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Tubo-ovarain abscess in patient with ovarian endometriosis DOI: https://doi.org/10.18203/2320-6012.ijrms20230190Keywords: Fallopian tube, Ovary, PID, TOAAbstract Tubo-ovarian abscess (TOA) is a sequela of pelvic inflammatory disease (PID) found in 15-34% of patients, is comprised of an infectious, inflammatory complex encompassing the fallopian tube and ovary. We are presenting a case of TOA with endometriosis in a patient who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological findings were compatible with endometriosis with xanthogranulomatous salpingitis and oophoritis. In our patient there was no history of any chronic infection, gynecological procedures or intra uterine device and single partner. The purpose of this case is to make aware of this condition and requirement of further studies to investigate the risk of TOA in patients with endometriosis to find out the exact cause to prevent unnecessary surgery at later stage. Metrics References Kavoussi SK, Pearlman MD, Burke WM, Lebovic DI. Endometrioma Complicated by Tubo-Ovarian Abscess in a Woman with Bacterial Vaginosis. Infect Diseases Obstetr Gynecol. 2006;84140:1-3. Chen M-J, Yang J-H, Yang Y-S, Ho H-N. Increased occurrenc of tubo-ovarian abscesses in women with stage III and IV endometriosis. Fertil Steril. 2004;82(2):498-9. Sen S, Singh K, Agarwal J, Sen G. A Massive Primary Ovarian Abscess within an Endometrioma in a Young Nullipara-An Unusual Case and Review of Literature. Fertil Reproduct. 2020;2(3):75-9. Cecilia LS, Rita ID, Gerson W. Infected endometriotic cysts: clinical characterization and pathogenesis. Fertil Steril. 1981;36(1):27-30. Gao Y, Qu P, Zhou Y, Ding W. Risk factors for the development of tubo‑ovarian abscesses in women with ovarian endometriosis: a retrospective matched case-control study. BMC Women’s Health. 2021;21(43):1-6. Abeysundara PK, Padumadasa GS, Tissera WGM, Wijesinghe PS. Xanthogranulomatous salpingitis and oophoritis associated with endometriosis and uterine leiomyoma. presenting as intestinal obstruction. J Obstet Gynaecol Res. 2012;38(8):1115-7. Muramoto T, Koike R. A Patient with Tubo-Ovarian Abscess with Endometriosis after Transvaginal Oocyte Retrieval. Open J Obstetr Gynecol. 2020;10:445-51. Mabrouk M, Di Donato N, Montanari G, Savelli L, Ferrini G, Seracchioli R. Do women with deep infiltrating endometriosis have more tubal alterations? Objective evaluation of 473 patients. J Reprod Med. 2013;58(9-10):417-24. Tas EE, Keskin HL, Akcay GFY, Ismayilova U, Yavuz AF. Association Between Endometriosis and Tubo-Ovarian Abscess. J Clin Gynecol Obstet. 2016;5(1):17-22. Lareau SM, Beigi RH. Pelvic inflammatory disease and tubo-ovarian abscess. Infect Dis Clin North Am. 2008;22(4):693-708. Kralickova M, Vetvicka V. Immunological aspects of endometriosis: a review. Ann Transl Med. 2015;3(11):153.

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