Background: A complete infectious focus survey relies on a thorough physical examination as well as a pelvic examination. Tubo-ovarian abscess, though less likely to occur in senior women, may become a life-threatening disease requiring emergent surgery. Hence, clinical awareness and aggressive management are warranted to avoid delayed diagnosis and subsequent complications.
Case Presentation: We report a post-menopausal woman presented with sepsis of unknown origin, which turned out to be a huge tubo-ovarian abscess. Although tubo-ovarian abscess mostly occurs in women of fertile age, it is likely that the immune status of our post-menopausal patient was compromised because of old age and uremia. Moreover, due to underlying dementia, she could not express her discomfort in the early stage. Her sepsis resolved after a unilateral salpingo-oophorectomy surgery and antibiotic treatment. It is crucial to exclude pelvic inflammatory disease (PID) if no specific source of infection can be identified.
Conclusions: Rupture of the tubo-ovarian abscess is a condition of high mortality rate. Although tubo-ovarian abscess is more likely to develop in patients aged 15-25 years old, the tubo-ovarian abscess should be listed as a differential diagnosis in all post-menopausal women, especially those who are immunocompromised or with a palpable pelvic mass, to enable timely management and better prognosis.
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http://dx.doi.org/10.1186/s12905-019-0782-6 | DOI Listing |
Clin Pract Cases Emerg Med
November 2024
Mount Sinai Morningside-Mount Sinai West, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.
Introduction: Point-of-care ultrasound (POCUS) is a screening and diagnostic modality frequently used in the emergency department to assess patients with abdominal pain.
Case Report: We present a case describing the unusual finding of intraperitoneal fluid with loculations visualized in the right upper quadrant of the abdomen in a patient ultimately diagnosed with pelvic inflammatory disease (PID) with ruptured tubo-ovarian abscess caused by group A streptococcus (GAS), a pathogen rarely implicated in the disease.
Conclusion: Uncommon findings on abdominal POCUS should trigger further investigation.
Am Fam Physician
December 2024
Indiana University School of Medicine, Indianapolis.
Acute abdominal pain in children is a common presentation in the clinic and emergency department settings and accounts for up to 10% of childhood emergency department visits. Determining the appropriate disposition of abdominal pain in children can be challenging. The differential diagnosis of acute abdominal pain, including gastroenteritis, constipation, urinary tract infection, acute appendicitis, tubo-ovarian abscess, testicular torsion, and volvulus, and the diagnostic approach vary by age.
View Article and Find Full Text PDFClin Imaging
November 2024
Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, United States of America.
Lancet Gastroenterol Hepatol
January 2025
Hospital du Haut-Leveque, Pessac, France.
Background: Approximately half of patients with Crohn's disease require ileocolonic resection. Of these, 50% will subsequently have endoscopic disease recurrence within 1 year. We aimed to evaluate the efficacy and safety of vedolizumab to prevent postoperative recurrence of Crohn's disease.
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