Current trends in the diagnosis and treatment of tuboovarian abscess

Daniel V. Landers, Richard L Sweet

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.

Original languageEnglish (US)
Pages (from-to)1098-1110
Number of pages13
JournalAmerican Journal of Obstetrics and Gynecology
Volume151
Issue number8
DOIs
StatePublished - Apr 15 1985

Fingerprint

Abscess
Salpingitis
Therapeutics
Contraception Behavior
Bacteroides fragilis
Intrauterine Devices
Bacteroides
Leukocytosis
Sexually Transmitted Diseases
Anti-Infective Agents
Laparoscopy
Laparotomy
Abdominal Pain
Fertility
Rupture
Fever
Hormones
Incidence

Keywords

  • chlamydia
  • pelvic inflammatory abscess
  • Tuboovarian abscess

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Current trends in the diagnosis and treatment of tuboovarian abscess. / Landers, Daniel V.; Sweet, Richard L.

In: American Journal of Obstetrics and Gynecology, Vol. 151, No. 8, 15.04.1985, p. 1098-1110.

Research output: Contribution to journalArticle

@article{8a624fd122fd49068f5faeb974eaf805,
title = "Current trends in the diagnosis and treatment of tuboovarian abscess",
abstract = "Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.",
keywords = "chlamydia, pelvic inflammatory abscess, Tuboovarian abscess",
author = "Landers, {Daniel V.} and Sweet, {Richard L}",
year = "1985",
month = "4",
day = "15",
doi = "10.1016/0002-9378(85)90392-8",
language = "English (US)",
volume = "151",
pages = "1098--1110",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "8",

}

TY - JOUR

T1 - Current trends in the diagnosis and treatment of tuboovarian abscess

AU - Landers, Daniel V.

AU - Sweet, Richard L

PY - 1985/4/15

Y1 - 1985/4/15

N2 - Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.

AB - Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.

KW - chlamydia

KW - pelvic inflammatory abscess

KW - Tuboovarian abscess

UR - http://www.scopus.com/inward/record.url?scp=0021845571&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021845571&partnerID=8YFLogxK

U2 - 10.1016/0002-9378(85)90392-8

DO - 10.1016/0002-9378(85)90392-8

M3 - Article

C2 - 3885746

AN - SCOPUS:0021845571

VL - 151

SP - 1098

EP - 1110

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 8

ER -