Image Diagnosis: Tubo-ovarian Abscess with Hydrosalpinx
Kiersten L Carter, MD; Gus M Garmel, MD, FACEP, FAAEM
Risk factors of tubo-ovarian Abscess include younger age, multiple sexual partners, nonuse of barrier contraception, and a history of pelvic inflammatory disease. Compared with ultrasonography, computed tomography has increased sensitivity to detect thick-walled, rim-enhancing adnexal masses. The aim of therapeutic management is to be as noninvasive as possible. However, if this approach fails to yield clinical improvement within 3 days, reassessment of the antibiotic regimen, with consideration for laparoscopy, laparotomy, adnexectomy, hysterectomy, or image-guided abscess drainage is necessary.