The document discusses the diagnosis and management of tubo-ovarian abscess (TOA). It notes that TOA involves an inflammatory mass of the fallopian tubes, ovaries, and sometimes other pelvic organs. Risk factors include being young, having multiple sexual partners, and a history of pelvic inflammatory disease. Diagnosis is usually made clinically with ultrasound or CT imaging. Treatment involves antibiotics initially, with imaging-guided drainage or surgery for more severe cases. The take-home message is that TOA is a continuum of pelvic inflammatory disease, usually treated medically with antibiotics.

1. Tubo-ovarian abscess
Diagnosis & Management
Dr/ wael Naeem M.
Assistant lecturer
Benha university hospitals

3. Our objectives
• Importance of the topic
• Definition
• Risk factors
• Diagnosis
• DD
• Management
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4. Historical back ground
• Mortality was 50 %
• Current mortality 1.7 – 3.7 (1960).
• NOW ……..????..
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5. A tubo-ovarian abscess (TOA)
• A tubo-ovarian abscess (TOA) is an
inflammatory mass involving the fallopian
tube, ovary and, occasionally, other adjacent
pelvic organs (eg, bowel, bladder). This may
manifest as a tubo-ovarian complex (an
agglutination of those structures) or a
collection of pus .
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6. Risk factors :
• Young age 15-25 years old.
• Multiple sexual partners .
• instrumentations of the uterus .
• IVF oocyte retrieval .
• IUD insertion .
• Previous history of PID .
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7. Etiology
• POLY MICROBIAL ….?????
• Routes of infections :
• 1-
• 2-
• 3-
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8. Clinical presentations
• Classic
• Atypical form :
• 40 %.
• 25 %.
• 23%.
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9. DD
• Ectopic .
• Ovarian cyst torsion , rupture, hemorrhage .
• Degenerated fibroid .
• Pyelonephritis .
• Appendicitis , Diverticulitis .
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10. Imaging
• U-S …
• C .T ….
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11. Ultrasound
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12. C T
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13. Treatment
• Antibiotic .
• Imaging guided drainage .
• Surgical intervention .
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14. Antibiotic
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20. Special situations
• A case with IUD ..
• A case with sepsis …
• Post menopausal …
• HIV case …
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21. Take home message
• TOA is continuum of PID .
• Diagnosed clinically with either U-S or CT
assistance .
• Treated mainly medically (70% success ).
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