The management of tubo-ovarian abscesses associated with appendicitis

Abstract

A relatively uncommon medical complication, the tubo-ovarian abscess (TOA) can result from ascending pelvic infection in the female genital tract. The paper aims at exploring the characteristics of patients with TOA and at comparing the outcomes of the surgical management with postoperative recovery. A retrospective analysis of 25 cases diagnosed with bilateral, right or left TOA at “St. Apostol Andrei” Emergency Clinical County Hospital Constanta, Romania between January 2019 and December 2020 was performed. The patients’ clinical characteristics, age, environment of origin, socio-economic background, educational level, the means of contraception used, surgical procedures, and postoperative recovery were analyzed. Out of the 25 cases, 40% presented bilateral TOA, 32% right TOA and 28% left TOA and left adnexectomy. In 3 patients (37.5%) with right TOA, appendicectomy was also performed. In 72% of the cases, a median pubicumbilical incision was performed. The remaining 7 patients (28%) with left TOA underwent Pfannenstiel incision. All cases had a favorable postoperative evolution, the patients being discharged 5-9 days after surgery, benefiting from antibiotic therapy 10 days after their discharge. The coexistence of appendicitis and adnexal pathology should raise awareness for adopting a surgical strategy in order to prevent postoperative complications.