An ovarian or fallopian tube abscess is one of the acute conditions in gynecology that requires immediate intervention. Too late action or implementation of inadequate therapeutic measures can lead to peritonitis, which in turn is an immediate life-threatening condition. What are the causes and symptoms of ovarian and fallopian tube abscess? What is the treatment?

An abscess of the ovary or fallopian tubeis caused by bacterial infections, inflammation involving the appendages, or sexually transmitted infections. The main complaints are severe abdominal pain and pain in the lower abdomen. An ultrasound examination is an excellent diagnostic tool. Antibiotic therapy is the treatment of choice, but in the absence of improvement, surgery is recommended.

On the basis of statistical data, only casuistically we are dealing with a simple lesion, ie involving the ovary itself. As a rule, an abscess affects the ovary and fallopian tube. It is relatively difficult to make a diagnosis because the condition in question produces very uncharacteristic symptoms that can be interpreted as symptoms of other disorders. It is even more difficult to recognize a change that is a chronic process.

Ovarian abscess: causes

The most common cause of an ovarian abscess is pelvic inflammation. The etiology of these disorders are mainly sexually transmitted diseases - chlamydiosis or gonorrhea. In addition, they can be intestinal bacteria, anaerobic bacteria, such as strainsBacteroidesor aerobic strains with a representative in the form ofE. coli . The pathogen transmission path depends on the type of pathogen. The intestinal bacteria can travel through the intestinal walls, which are inflamed and perforated, which makes this process easier for them. In turn, bacteria responsible for venereal diseases can enter the pelvis directly through the cervix or the endometrium.

Diagnostics of ovarian abscess and clinical picture

An ovarian abscess, or more specifically the ovarian-tubal abscess, is usually located unilaterally. The clinical picture is the same for many disease states, therefore it can simulate many disease processes. The most characteristic symptoms are:

  • nodular change palpable during the examinationpalpation
  • severe pain, symptoms also felt during palpation
  • general symptoms: increased body temperature, tachycardia, increased levels of inflammatory markers in laboratory tests - CRP protein, leukocytosis.

There are many theories about the formation of ovarian abscesses. Many of them are directly related to inflammation in the smaller pelvis.

The interview with the patient, even the most precisely collected, is not very helpful in making the diagnosis and implementing the appropriate therapeutic procedure.

Such inflammation may result from insertion of an IUD, curettage of the uterine cavity, hysterosalpingography. An ovarian abscess does not only concern strictly gynecological patients. They can be women after a miscarriage or childbirth. Some have suggested that transmission of bacteria may also occur after a simple rupture of the ovulatory follicle.

Acute abdomen and ovarian abscess

An ovarian abscess, in addition to the above-mentioned symptoms, may also manifest itself as a typical clinical picture of an acute abdomen:

  • plank belly
  • positive peritoneal symptoms, including Blumberg's symptom, which is positive if the patient feels the moment when the examiner's hand is detached from the abdominal wall more clearly than when it is applied
  • intestinal motility disorders, more specifically peristalsis disorders
  • increased body temperature

Ovarian abscess: differential diagnosis

Symptoms of an acute abdomen, especially increased abdominal tension, positive peritoneal symptoms, flatulence, and peristalsis disorders are the same for many abdominal inflammations. In all cases, appendicitis, diverticulitis, intestinal obstruction, ovarian torsion, and a ruptured ectopic pregnancy should be excluded. It happens that some electrolyte disturbances or decompensated diabetes suggest peritonitis.

Treatment of ovarian abscess

The diagnosis of an ovarian abscess should be made on the basis of the patient's clinical picture and ultrasound examination. In the absence of damage to the abscess wall and the evacuation of pathological contents into the peritoneal cavity, conservative treatment may be applied. Then, broad-spectrum antibiotic therapy is quite sufficient.

A much worse clinical situation is the spilling of the abscess content. The only solution is a surgical procedure that involves removing the diseased appendages and draining the peritoneal cavity.

Treatment of an ovarian abscess does not eliminate the risk of complications. It really isany inflammatory process within the peritoneal cavity is associated with the formation of peritoneal adhesions, which can be a serious obstacle in maternal plans. Much more frequent is the incorrect implantation of the embryo outside the uterine cavity, i.e. ectopic pregnancy. Past ovarian abscesses can also cause intestinal obstruction.

Worth knowing

Fitz-Hugh-Curtis syndrome

A very rarely diagnosed syndrome in which abscesses of the ovary or fallopian tube are present. It is a complication of sexually transmitted diseases, mainly chlamydia and gonorrhea. This infection is transmitted ascending through the cervix to the endometrium, then through the appendages to the peritoneal cavity. The target site of bacteria is the liver and gallbladder. Symptoms are similar to those associated with inflammation of the gallbladder: nausea, vomiting, excessive tenderness in the ejection of the gallbladder. Therapeutic management is consistent with the routine treatment of simple ovarian abscesses.

Category:

Female diseases