The management of pelvic abscess.
The optimum treatment for pelvic abscess would be an approach that is safe, efficacious, cost-effective, minimally invasive, and which affects the woman's fertility potential as little as possible. In women of reproductive age tubo-ovarian abscess is one of the most common types of pelvic abscess. Tubo-ovarian abscesses are classically treated with broad-spectrum antibiotics. Frequently this approach fails and surgical intervention becomes necessary in about 25% of all cases. Surgical procedures include laparotomy or laparoscopy with drainage of abscess, unilateral or bilateral salpingo-ophorectomy, and hysterectomy. However, surgery for tubo-ovarian abscess is often technically difficult and associated with complications. An alternative approach is the use of imaging-guided drainage of abscess in combination with antibiotics. Combined data from several studies indicate that ultrasound-guided transvaginal drainage with concomitant antibiotics is especially safe and efficacious. This chapter discusses the management of pelvic abscess with a special focus on transvaginal ultrasound-guided drainage of tubo-ovarian abscess.
Granberg
Seth
S
Department of Obstetrics and Gynaecology, Akershus University Hospital, 1478 Lørenskog, Norway. sethg@online.no
Gjelland
Knut
K
Ekerhovd
Erling
E
D015746:Abdominal Pain / Q000209:etiology; D000038:Abscess / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D023341:Chills / Q000209:etiology; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D018084:Ultrasonography, Interventional
D000900:Anti-Bacterial Agents