Tubo-ovarian abscess: Diagnosis, medical and surgical management

Krivak, Thomas C.; Cooksey, Christie; Propst, Anthony M.

doi:10.1007/s12019-004-0003-5

Cited by 29 publications

(19 citation statements)

References 35 publications

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“…For example, diverticulitis has evolved into a medically managed disease with surgery reserved for cases in which medical therapy fails (39–41). In addition, similar transitions to primarily medical management have occurred with intra-abdominal abscesses from Crohn’s disease and acute suppurative salpingitis (42, 43). Over the last 20 years, appendicitis has also evolved to incorporate alternative treatment strategies based on severity of illness.…”

Section: Discussionmentioning

confidence: 94%

Feasibility of a Nonoperative Management Strategy for Uncomplicated Acute Appendicitis in Children

Minneci

Sulkowski

Nacion

et al. 2014

Journal of the American College of Surgeons

110

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Background Urgent operation has been considered the only appropriate management of acute appendicitis in children for decades. The purpose of this study was to investigate the feasibility of non-operative management of uncomplicated acute appendicitis in children. Study Design A prospective non-randomized clinical trial of children with uncomplicated acute appendicitis comparing non-operative management to urgent appendectomy was performed. The primary outcome is the 30-day success rate of non-operative management. Secondary outcomes include comparisons of disability days, missed school days, hospital length of stay (LOS), and measures of quality of life and healthcare satisfaction. Results Seventy-seven patients were enrolled during October 2012–October 2013; 30 chose non-operative management and 47 chose surgery. There were no significant differences in demographic or clinical characteristics. The immediate and 30-day success rates of non-operative management were 93% (n=28/30) and 90% (n=27/30). There was no evidence of progression of appendicitis to rupture at the time of surgery in the three patients that failed non-operative management. Compared to the surgery group, the non-operative group had fewer disability days (3 vs. 17 days, p<0.0001), returned to school more quickly (3 vs. 5 days, p=0.008), and exhibited higher quality of life scores in both the child (93 vs. 88, p=0.01) and the parent (96 vs. 90, p=0.03), but incurred a longer LOS (38 vs. 20 hours, p<0.0001). Conclusions Non-operative management of uncomplicated acute appendicitis in children is feasible with a high 30-day success rate and short-term benefits including a quicker recovery and improved quality of life scores. Additional follow-up will allow for determination of a longer-term success rate, safety, and cost-effectiveness.

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Section: Discussionmentioning

confidence: 94%

Feasibility of a Nonoperative Management Strategy for Uncomplicated Acute Appendicitis in Children

Minneci

Sulkowski

Nacion

et al. 2014

Journal of the American College of Surgeons

110

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“…The initial medical management for an unruptured TOA is the use of broad-spectrum antibiotics. If there is no response to antibiotic therapy, then minimally invasive abscess drainage or a surgical approach to treatment, including laparoscopy or laparotomy, is essential [25]. Gjelland et al [26] reported that transvaginal ultrasound-guided aspiration together with antibiotic therapy for the treatment of TOA was a successful treatment in 93.4% of cases.…”

Section: Discussionmentioning

confidence: 99%

Predictive Markers of Tubo-Ovarian Abscess in Pelvic Inflammatory Disease

Lee

Rhim

Kim

et al. 2015

Gynecol Obstet Invest

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Background/Aims: The purpose of this study was to identify predictive markers for tubo-ovarian abscess (TOA) through a comparison of clinical and laboratory data in patients diagnosed with pelvic inflammatory disease (PID). Methods: We reviewed the medical charts of 499 females who were admitted to hospital with clinical, surgical, imaging-based diagnoses of PID between 2001 and 2011. The patients were divided into the following two groups: (1) PID with TOA and (2) PID without TOA. Results: The TOA and non-TOA groups were comprised of 69 and 430 females, respectively. Mean age, history of intrauterine device (IUD) insertion and inflammatory markers, including erythrocyte sedimentation rate, C-reactive protein (CRP) and CA-125 levels, were higher in the TOA group than the non-TOA group. Independent factors that predicted TOA were older age, IUD insertion, increased CRP and CA-125, and chlamydia infection. CA-125 was found to have the highest predictive value for TOA. TOA size was associated with increased surgical therapy compared to patients with smaller abscesses. Conclusions: Increased age, IUD insertion, chlamydia infection, and increased CRP and CA-125 level were the independent factors predictive of TOA in acute PID. These predictive values will be expected to help decrease gynecological morbidity by early diagnosis and appropriate treatment of TOA.

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“…Imaging modalities may include transvaginal ultrasound, computed tomography and magnetic resonance imaging, with transvaginal ultrasound regarded especially helpful in the diagnosis of TOA [2,8].…”

Section: Discussionmentioning

confidence: 99%

Tubo-ovarian abscess in woman with an intrauterine device forgotten for 22 years

et al. 2010

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We report on a case of pelvic inflammatory disease in a 53 year old woman using an intrauterine contraceptive device (IUD) for a time period of 22 years. Clinical symptoms were fever up to 38°C and severe abdominal pain. Endoscopic findings were a tubo-ovarian abscess of the complete pelvis and a forgotten IUD with a smear positive for Escherichia coli and Candida albicans. The patient was treated with a surgical therapy and by antibiotic combination. Diagnosis was performed by histopathological examination.

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Tubo-ovarian abscess: Diagnosis, medical and surgical management

Cited by 29 publications

References 35 publications

Feasibility of a Nonoperative Management Strategy for Uncomplicated Acute Appendicitis in Children

Feasibility of a Nonoperative Management Strategy for Uncomplicated Acute Appendicitis in Children

Predictive Markers of Tubo-Ovarian Abscess in Pelvic Inflammatory Disease

Tubo-ovarian abscess in woman with an intrauterine device forgotten for 22 years

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