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Management and complications of tubo-ovarian abscess

Richard H Beigi, MD, MSc
Section Editors
Howard T Sharp, MD
Daniel J Sexton, MD
Deputy Editor
Sandy J Falk, MD, FACOG


A tubo-ovarian abscess (TOA) is an inflammatory mass involving the fallopian tube, ovary and, occasionally, other adjacent pelvic organs (eg, bowel, bladder) [1]. These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection.

TOA is a serious and potentially life-threatening condition. Aggressive medical and/or surgical therapy is required and rupture of an abscess may result in sepsis. Prior to the advent of broad-spectrum antibiotics and modern surgical practice, the mortality rate associated with TOA was approximately 50 percent or higher [2,3].

The mortality rate approaches zero for abscesses that are not ruptured. For patients with ruptured abscesses, current mortality rates have not been reported, but data from the 1960s suggest the rate may be as high as 1.7 to 3.7 percent [2,4,5].

Treatment modalities for TOA include intensive antibiotic therapy, minimally-invasive drainage procedures, invasive surgery, or a combination of these interventions. The large majority of small abscesses (<9 cm in diameter) resolves with antibiotic therapy alone.

The management of tubo-ovarian abscesses is reviewed here. The epidemiology, diagnosis and evaluation of tubo-ovarian abscesses are discussed separately. Other manifestations of pelvic inflammatory disease are discussed separately. (See "Epidemiology, clinical manifestations, and diagnosis of tubo-ovarian abscess" and "Pelvic inflammatory disease: Pathogenesis, microbiology, and risk factors" and "Pelvic inflammatory disease: Clinical manifestations and diagnosis" and "Pelvic inflammatory disease: Treatment" and "Long-term complications of pelvic inflammatory disease".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 11, 2016.
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