- Imaging as an alternate diagnostic modality in a presumptive case of abdominopelvic TB in a COVID-19 patient. [Journal Article]BMJ Case Rep. 2021 Mar 02; 14(3)BC
- A 30-year-old, multiparous widow, with postpolio residual paralysis, presented with complaints of dull aching abdominal pain for 15 days. Ultrasound showed a mixed echogenic right adnexal mass with free fluid in the pelvis and abdomen. CT abdomen and pelvis revealed partially defined peripherally enhancing collection in lower abdomen and right adnexa suggestive of tubo-ovarian abscess. There was …
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- The prediction of surgical intervention in patients with tubo-ovarian abscess. [Journal Article]J Obstet Gynaecol. 2021 Feb 25 [Online ahead of print]JO
- The aim of this study was to compare the clinical characteristics of patients with tubo-ovarian abscess (TOA) who responded to medical treatment and those who underwent surgical intervention due to medical treatment failure. Electronic medical records were evaluated retrospectively to identify patients who were diagnosed with TOA. Demographic, clinical, and laboratory data including white blood c…
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- How to approach the rupture of tubo-ovarian abscess during pregnancy: A case report and literature review. [Case Reports]J Obstet Gynaecol Res. 2021 Mar; 47(3):1199-1203.JO
- We present the case of a 26-year-old multiparous woman who experienced rupture of a tubo-ovarian abscess during the second trimester of pregnancy. She presented with epigastric and right lower quadrant pain at 12 + 0 weeks' gestation. There were no other specific findings on the magnetic resonance imaging images. We recommended hospitalization to observe the changes in pain, but she refused confi…
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- Risk factors for the development of tubo-ovarian abscesses in women with ovarian endometriosis: a retrospective matched case-control study. [Journal Article]
- CONCLUSIONS: Among the factors investigated, genital tract infections and spontaneous rupture of ovarian endometriosis cysts were found to be involved in the occurrence of tubo-ovarian abscesses associated with ovarian endometriosis. Our findings indicate that tubo-ovarian abscesses associated with ovarian endometriosis may not be linked to in vitro fertilization as previously thought.
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- Teaching the Evaluation of Female Pelvic Pain: A Hands-On Simulation to Reinforce Exam Skills and Introduce Transvaginal Ultrasound. [Journal Article]
- Reproductive-age female patients commonly seek evaluation for pelvic pain in a variety of health care settings. Thus, teaching medical students how to effectively evaluate female pelvic pain is a necessary part of medical education. There are limited opportunities, however, to reinforce the needed skills for this common but sensitive presentation that can be anxiety-producing for preclinical stud…
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- Can antibiotic treatment failure in tubo-ovarian abscess be predictable? [Journal Article]Eur J Obstet Gynecol Reprod Biol. 2021 Mar; 258:253-257.EJ
- CONCLUSIONS: Especially in large tubo-ovarian abscesses, early surgical intervention should be preferred considering the age, BMI, and CRP values.
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- Brucella pelvic tubo-ovarian abscess with a history of chronic brucellosis. [Case Reports]
- Brucellosis is a zoonotic disease located especially in Central and South America, India, the Mediterranean and the Middle East. Human brucellosis occurs as a systemic infectious disease with various clinical manifestations. We present a case of 45-year-old female patient, nulliparous, not sexually active, with a previous medical history of a treated brucellosis, and no surgical or gynecological …
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- Epidemiologic and Clinical Characteristics of Tubo-Ovarian Abscess, Hydrosalpinx, Pyosalpinx, and Oophoritis in Emergency Department Patients. [Journal Article]
- Introduction Pelvic inflammatory disease (PID) is a spectrum of illness ranging from mild illness to more severe forms including tubo-ovarian abscess, hydrosalpinx, pyosalpinx, oophoritis (THPO). The objective of the study was to report rates and clinical characteristics of females presenting to the ED with a diagnosis of THPO in relationship to the presence or absence of sexually transmitted inf…
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- Tubo-Ovarian Abscess in Non-Sexually Active Adolescent Girls: A Case Series and Literature Review. [Journal Article]J Pediatr Adolesc Gynecol. 2020 Dec 16 [Online ahead of print]JP
- CONCLUSIONS: These cases, in conjunction with previous case reports, emphasize the importance of considering TOA in patients with concerning imaging or examination findings despite lack of sexual activity. Given the large proportion of cases attributable to anaerobic gut flora, treatment with antibiotics with adequate anaerobic coverage is recommended. Surgical drainage is not always necessary, but is often needed for diagnostic purposes or in patients not clinically improving with conservative measures.
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- A novel case of bilateral tubo-ovarian abscesses attributed to Ruminococcus gnavus without gastrointestinal involvement. [Case Reports]Anaerobe. 2021 Feb; 67:102312.A
- Ruminococcus gnavus is a Gram-positive anaerobe and normal gut commensal in the human host. There have been a small number of reported cases of infections attributed to R. gnavus, and no cases of urogenital infections have previously been published. We describe here a case of bilateral tubo-ovarian abscesses (TOAs) which cultured a pure growth of R. gnavus in a young female with concurrent deep i…
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- Impact of early surgical management on tubo-ovarian abscesses. [Journal Article]J Obstet Gynaecol. 2020 Nov 28 [Online ahead of print]JO
- This 5-year retrospective study aimed to investigate whether early surgical management improves outcomes in patients presenting with a tubo-ovarian abscess (TOA). Patient characteristics, investigation results and treatment outcomes were compared. 50 women were diagnosed with a TOA during the study period. Nineteen (38.0%) were treated with antibiotics (medical group) and thirty one (62.0%) were …
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- Unexpected finding of urachal remnant cyst. Tips for laparoscopic approach. [Case Reports]
- CONCLUSIONS: The urachal cyst, which results from the accumulations of secretions in urachal remnant, presents as a single or multiple parietal abdominal mass, per se asymptomatic. However, this condition is not without risk and infection represents the most common complication. Ultrasound is very useful in the diagnostic phase. Today, the main approach has become laparoscopic excision, with particular attention to a radical removing of the mass, due to high recurrence rate and the risk of malignancy.In our experience, laparoscopy represents an excellent diagnostic and therapeutic tool for urachal cyst, especially for patients with acute urgent conditions, doubtful clinical history, and no clear signs or symptoms.
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- Sexually Transmitted Infections Part 2: Discharge Syndromes and Pelvic Inflammatory Disease. [Review]Pediatr Rev. 2020 Oct; 41(10):522-537.PR
- Sexually transmitted infections (STIs) disproportionately affect young people, with more than half of the infections occurring in youth aged 15 to 25 years. (1)(2) This review, the second in a 2-part series on STIs, focuses on infections that may cause abnormal vaginal or penile discharge, including trichomonas, chlamydia, gonorrhea, and pelvic inflammatory disease (PID). Most infected persons, h…
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- Outcomes of Minimally Invasive Management of Tubo-ovarian Abscess: A Systematic Review. [Review]J Minim Invasive Gynecol. 2020 Sep 28 [Online ahead of print]JM
- CONCLUSIONS: Although conservative management of TOAs with antibiotics alone remains first-line, our review indicates that better outcomes in the management of TOA were achieved by minimally invasive approach compared with conservative treatment with antibiotics only. Of the minimally invasive techniques, image-guided drainage of TOAs provided the highest success rates, the fewest complications, and the shortest hospital stays compared with laparoscopy. The low magnitude of evidence in the included studies calls for further randomized trials. This systematic review was registered in the International Prospective Register of Systematic Review (register, http://www.crd.york.ac.uk/PROSPERO;CRD 42020170345).
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- Perioperative Complications of Laparoscopic versus Open Surgery for Pelvic Inflammatory Disease. [Journal Article]J Minim Invasive Gynecol. 2020 Sep 04 [Online ahead of print]JM
- CONCLUSIONS: Laparoscopy was associated with lower complication rates than open surgery in this well-matched cohort of patients who underwent surgery for acute PID.
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- Renal and perinephric abscesses involving Lactobacillus jensenii and Prevotella bivia in a young woman following ureteral stent procedure. [Case Reports]
- is a gram-positive bacillus in the female genital tract believed to be a commensal organism that inhibits the growth of more virulent pathogens. Prevotella bivia is a gram-negative bacillus species also typically commensal in the female genital tract. Lactobacillus as the primary causative agent in perinephric abscesses and bacteremia has been documented, albeit very uncommon and opportunistic. P…
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- [Management of Pelvic Inflammatory Disease]. [Journal Article]Ther Umsch. 2020; 77(4):164-170.TU
- Management of Pelvic Inflammatory Disease Abstract. Pelvic inflammatory disease (PID) is a common medical problem, but the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. As PID might cause late complications such as infertility or chronic pelvic pain, it is of prime importance that the diagnosis of PID is made promp…
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- A Rare Pelvic "Mass-Querader": Acute Urinary Retention Secondary to Hematocolpos in a Preadolescent Patient. [Journal Article]Mil Med. 2020 12 30; 185(11-12):2171-2172.MM
- We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detec…
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- Retrospective study on the efficacy and prognostic factors of conservative versus drainage of tubo-ovarian abscesses. [Journal Article]Arch Gynecol Obstet. 2020 09; 302(3):679-683.AG
- CONCLUSIONS: Patients who are above 40 years, febrile and have a larger TOA are at a higher risk of medical treatment failure, and should, therefore, be recommended for primary drainage at presentation. Further prospective studies should be conducted with a larger sample size to compare the outcomes of conservative management versus drainage of TOA.
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- Pneumoperitoneum due to ruptured tubo-ovarian abscess. [Journal Article]ANZ J Surg. 2021 01; 91(1-2):204-205.AJ
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- Inflammation calls for more: Severe pelvic inflammatory disease with or without endometriosis. Outcomes on 311 laparoscopically treated women. [Journal Article]J Gynecol Obstet Hum Reprod. 2021 Mar; 50(3):101811.JG
- CONCLUSIONS: This study seems to confirm an higher prevalence of pelvic inflammatory disease in endometriosis patients. Intra-operative findings of PID with associated endometriosis show more aggressive patterns.
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- Tubo-ovarian abscess in postmenopausal women: A systematic review. [Review]
- CONCLUSIONS: TOA is not a frequent finding in postmenopausal women. Yet, it may lead to or mask significant morbidity or mortality. A somewhat surprising risk factor for TOA in postmenopausal women is the presence or following removal of a longstanding IUD. The risk of malignancy is lower than previously described.
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- A Curious Case of Blastomyces Osteomyelitis. [Case Reports]
- Blastomycosis is an uncommon disease caused by the dimorphic fungus, Blastomyces dermatitidis, often found in endemic regions of Midwestern America. It can be found in forested, sandy soils, decaying vegetation, rotting wood near water sources, and even in bird feces. Most commonly, blastomycosis manifests as a pulmonary infection presenting as pneumonia, or in severe cases, respiratory distress …
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- Early diagnosis and treatment challenges of endodermal sinus tumors: A case report. [Case Reports]
- CONCLUSIONS: ESTs are extremely aggressive and require prompt referral and early treatment with chemotherapy. Presenting symptoms of pain and a mass can lead to a broad range of differential diagnoses. In such patients, early consideration of tumor markers is warranted. This case report reviews the key aspects for prompt diagnosis and rapid treatment of these tumors, which significantly impacts the prognosis.
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- Concurrent Escherichia coli tubo-ovarian abscess and Campylobacter jejuni gastroenteritis: A case report. [Case Reports]
- Haematogenous or direct spread of bacterial infection causing pelvic inflammatory disease of the upper female reproductive tract is uncommon. We report a diagnostically challenging case of a 41-year-old woman with a background of Stage 4 endometriosis presenting with fever, diarrhoea and abdominal pain with recent history of pyelonephritis. Initially managed for undifferentiated abdominal pain wi…
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- Safety and Assisted Reproductive Technology Outcomes of Hysteroscopic Tubal Microinserts Versus Laparoscopic Proximal Tubal Occlusion or Salpingectomy for Hydrosalpinges Treatment. [Journal Article]J Obstet Gynaecol Can. 2020 06; 42(6):779-786.JO
- CONCLUSIONS: Pregnancy outcomes after hysteroscopic placement of a microinsert for hydrosalpinx management before embryo transfer were comparable to those following laparoscopic proximal tubal occlusion or salpingectomy. However, caution is advised regarding microinsert placement for hydrosalpinges before proceeding with assisted reproductive technology.
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- A Case of a False-Positive Urine Pregnancy Test and Delayed Diagnosis of Obstructive Pyelonephritis. [Case Reports]
- CONCLUSIONS: This case of a false-positive urine pregnancy test in a 28-year-old woman with a history of tubal ligation highlights that this association may result in the delay in the diagnosis and treatment of acute pyelonephritis.
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- Pelvic inflammatory disease among users and non-users of an intrauterine device. [Journal Article]J Obstet Gynaecol. 2021 Jan; 41(1):118-123.JO
- The correlation between pelvic inflammatory disease (PID) and a present intrauterine device (IUD) has been debated. We aimed to evaluate the differences between IUD users and non-users among women hospitalised with a diagnosis of PID. Our hypothesis was that the role of a present IUD among PID patients is minimal, if any. We performed a retrospective cohort study during 2010-2018 in a tertiary un…
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- Pelvic inflammatory diseases: Updated French guidelines. [Review]
- Pelvic inflammatory diseases (PID) must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to rule out tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combine…
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- Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. [Case Reports]
- Pneumoperitoneum seen on an X-ray or computed tomography (CT) image points to a diagnosis of ruptured viscus and immediate surgery is warranted. A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. Very few cases have been reported where the pneumoperitoneum is caused by an abscess involving the adnexa. We present the case of a 17-year-old patient who presented with a…
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