Tubo-ovarian Abscess in Diverse Age-groups: A Case Series

Aim:The purpose of the study is to discuss the presentation and management of tubo-ovarian abscess (TOA) in diverse age-groups at ESIC Medical College and Hospital, Chennai.Materials and methods: It is a case series study of women who presented with symptoms and signs of TOA, from October 2020 to September 2023 at ESIC Medical College and Hospital, Chennai, Tamil Nadu, India.Comprehensive clinical evaluation, blood investigations including tumor markers, ultrasonography of abdomen and pelvis, pus culture and sensitivity from the site of infection at the time of surgery were done.The kind of surgical procedure done, and the histopathological reports were studied.Informed consent were taken from all the patients for publication.Results: The patients in this case series presented with either fever, abdominal pain, or mass per abdomen.Laparotomy was required for all patients as there were no improvement in symptoms with the presence of palpable abominopelvic mass not responding to intravenous antibiotics and the size of the mass was more than 8 cm.Age of the patients ranged between 19 and 60 years.Conclusion: Women who present with fever, abdominal pain and distension with tender palpable abominopelvic masses require inpatient aggressive management to arrive at a prompt diagnosis.This will enable the gynecologist to provide timely surgical management, the primary aim being minimally invasive and as conservative as possible, to avoid complications due to rupture.Intraoperatively, pus culture and sensitivity from the site of infection and tissue sent for histopathology are mandatory to arrive at a correct diagnosis and provide appropriate treatment for better prognosis and successful outcome.Clinical significance: Tubo-ovarian abscess not responding to intravenous antibiotics requires urgent surgical intervention as huge abscesses may rupture and pose serious threat to patient's life.