Gynecologic abscess: CT-guided percutaneous drainage.
A 42-year-old woman with recurrent bilateral endometrial ovarian cystoma presented with fever and pelvic pain caused by a tubo-ovarian abscess (TOA), which was resistant to several varieties of intravenous and oral antibiotics for 2 weeks (Case 1). Computed tomography (CT)-guided diagnostic aspiration for a rapid enlarged right ovarian cystoma through a transabdominal route confirmed that it had developed into a TOA. Subsequent percutaneous abscess drainage (PAD) and irrigation for 3 days were successful. One-year follow-up revealed no recurrence of TOA. A 58-year-old woman with recurrent cervical cancer after external radiation therapy (RT) presented with fever, confusion and tremor caused by pyometra (Case 2). Since transvaginal drainage was impossible due to cervical os obstruction, the patient had undergone CT-guided transabdominal PAD and irrigation for a month. Thereafter, the clinical findings improved and a tracheloplasty was performed to prevent recurrence. CT-guided PAD may be a useful treatment option for gynecologic abscess as a diagnostic aspiration, a temporizing procedure until surgery, or an alternative surgery.
Kakizawa
Hideaki
H
Department of Radiology, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan. kakizawa@hiroshima-u.ac.jp
Toyota
Naoyuki
N
Hieda
Masashi
M
Hirai
Nobuhiko
N
Tachikake
Toshihiro
T
Matsuura
Noriaki
N
Fujimura
Yoshio
Y
Kodama
Ichiro
I
Hirata
Eiji
E
Hara
Tetsuaki
T
Ito
Katsuhide
K
D000038:Abscess / Q000628:therapy*; D000328:Adult; D004322:Drainage / Q000379:methods*; D005184:Fallopian Tube Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014591:Uterine Diseases / Q000628:therapy*