IMR Press / CEOG / Volume 30 / Issue 2-3 / pii/2003028

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

Tuba-ovarian abscesses: Spectrum of sonographic findings with surgical and pathological correlations

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1 Department of Gynaecology, “G. Gennimatas” General Hospital, Athens, Second District National Health System, Athens (Greece)
2 Department of Gynaecology, “G. Gennimatas” General Hospital, Athens, Second District National Health System, Athens (Greece)
3 Department of Obstetrics and Gynaecology, “G. Chatzikosta” General State Hospital, Joannina, District National Health System, Epirus (Greece)
Clin. Exp. Obstet. Gynecol. 2003, 30(2-3), 117–121;
Published: 10 June 2003
Abstract

Objective: Pelvic inflammatory disease (PID) is a serious condition that can lead to abscess formation. The purpose of this study was to identify the different sonographic markers on gray scale and color Doppler sonography in tubo-ovarian abscesses. Material and Methods: The study group consisted of 25 women in whom the presence of tuboovarian abscess was confirmed by surgery and histopathology and their ultrasound records were analyzed retrospectively. Results: Presence of a mass was found in all cases. The maximum diameter of the mass was 5 cm in two cases and between 5 cm and 10 cm in 23 cases. The mass was demonstrated at the anatomic position of the ovary in 21 cases (84%) and at the culdesac in four cases (16%). The mass was a simple cyst in two cases (8%), in four cases it was cystic with diaphragms (16%), in four cases it was a thickened tube-shaped structure with multiple internal echoes (16%) and in 15 cases it was a mixture of cystic and solid elements (60%). Pyosalpinges with fluid-fluid levels were found in two cases. Fluid in the cul-de-sac was observed at a rate of 48%. Color Doppler sonography demonstrated abundant blood flow in the borders and the septa of the tuboovarian abscesses in 90% of the studied cases. Conclusion: The ultrasonographic findings of abscesses are not specific. The presence of a mass at the anatomic position of the ovary or at the cul-de-sac in combination with an increased number of white blood cells, elevated erythrocyte sedi­mentation rate and clinical findings are helpful for a correct diagnosis. Also, the color Doppler flow can further characterize the nature of the pelvic mass by detecting a significant rich blood flow in most cases of tuboovarian abscesses.

Keywords
Ultrasound
Abdominal
Transvaginal
Tubo-ovarian abscess
Pelvic inflammatory disease
Color Doppler
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