A case of the intractable tubo-ovarian abscess with endometriosis after appendectomy.

M Araki, Takashi Mimura, Tetsuya Ishikawa, Kosuke Totake, Shin Takenaka, Hanako Shimizu, Chiaki Iizuka, Shingo Miyamoto, Miki Morioka, Akihiko Sekizawa
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2015 · vol. 30(2) , pp. 455–458 · doi:10.5180/jsgoe.30.455 · W2322014451
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This case report describes a 30-year-old woman with an intractable tubo-ovarian abscess associated with endometriosis who required CT-guided drainage and prolonged antibiotics after relapsing from initial laparoscopic treatment.

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This case report describes a 30-year-old woman who developed a tubo-ovarian abscess associated with an endometrioma following an appendectomy. Initial treatment involving antibiotic therapy and laparoscopic surgery failed due to relapse caused by multiple-drug-resistant bacteria, necessitating a second CT-guided drainage procedure and prolonged antibiotic administration. The authors highlight the clinical challenge of managing complex pelvic infections in patients with pre-existing endometriotic cysts. This paper is centrally about endometriosis — specifically the complication of an endometrioma becoming infected and forming a tubo-ovarian abscess.

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Abstract

Background: A tubo-ovarian abscess (TOA) is an inflammatory mass involving the fallopian tube, ovary, and occasionally the other adjacent pelvic organs. These abscesses are found most commonly in women of reproductive age and are typically resulted from ascending infection of genital tract. Treatment modalities for TOAs include intensive antibiotic therapy, minimally-invasive drainage procedures, invasive surgery, or combination of these interventions.Case: A 30 years-old woman had a TOA with endometrioma after appendectomy. We treated her by anti-biotic therapy and laparoscopic surgery. But, her TOA relapsed as a severe infection of multiple-drug-resistant bacteria. Therefore, we performed a secondly CT-guided-drainage of the abscess and long course of antibiotic therapy.
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症例報告 虫垂炎術後に発症し治療に苦渋した子宮内膜症性嚢胞の膿瘍化の1例 2015 年 30 巻 2 号 p. 455-458 詳細 抄録 Background: A tubo-ovarian abscess (TOA) is an inflammatory mass involving the fallopian tube, ovary, and occasionally the other adjacent pelvic organs. These abscesses are found most commonly in women of reproductive age and are typically resulted from ascending infection of genital tract. Treatment modalities for TOAs include intensive antibiotic therapy, minimally-invasive drainage procedures, invasive surgery, or combination of these interventions. Case: A 30 years-old woman had a TOA with endometrioma after appendectomy. We treated her by anti-biotic therapy and laparoscopic surgery. But, her TOA relapsed as a severe infection of multiple-drug-resistant bacteria. Therefore, we performed a secondly CT-guided-drainage of the abscess and long course of antibiotic therapy. Case: A 30 years-old woman had a TOA with endometrioma after appendectomy. We treated her by anti-biotic therapy and laparoscopic surgery. But, her TOA relapsed as a severe infection of multiple-drug-resistant bacteria. Therefore, we performed a secondly CT-guided-drainage of the abscess and long course of antibiotic therapy. © 2015 日本産科婦人科内視鏡学会

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