Percutaneous catheter drainage of tubo-ovarian abscesses.
We present the successful treatment of tubo-ovarian abscesses in three young patients by continuous percutaneous drainage, inserted under the guidance of real-time ultrasonography using only local anesthesia. Each patient had been diagnosed laparoscopically as suffering from acute pelvic inflammatory disease, but had formed abscesses despite extensive broad-spectrum antibiotic therapy. One case involved a complication of the ovum pick-up procedure; the woman had tubo-ovarian abscesses with infected hematomas. Because the abscesses were localized anteriorly in the lower abdomen and did not reach the pouch of Douglas, they could not be drained through a posterior colpotomy. Ultrasound guidance allowed us to drain all the areas of the multioculated abscesses. We suggest that percutaneous abscess drainage be the initial treatment of choice for tubo-ovarian abscesses before laparotomy is considered.
Shulman
A
A
Department of Obstetrics and Gynecology "B", Sapir Medical Center, Kfar Saba, Israel.
Maymon
R
R
Shapiro
A
A
Bahary
C
C
D000038:Abscess / Q000628:therapy*; D000328:Adult; D004322:Drainage / Q000379:methods*; D004927:Escherichia coli Infections / Q000628:therapy*; D005184:Fallopian Tube Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000628:therapy*; D013203:Staphylococcal Infections / Q000628:therapy*; D014463:Ultrasonography / Q000379:methods