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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 confinement. About 3 weeks later, she revisited our emergency room at 15 + 4 weeks' gestation. She complained of worsening abdominal pain with fever. She underwent right salpingo‐oophorectomy and appendectomy due to uncontrollable, severe abdominal pain without any obstetric abnormal condition. There was a rupture site in the right adnexa, which was covered with pus. The rupture of tubo‐ovarian abscess during pregnancy is very rare. Therefore, obstetricians should carefully monitor the adnexal masses observed during pregnancy, which should be treated with caution, whether or not the patient is symptomatic. [ABSTRACT FROM AUTHOR]

Aim Inflammation of the upper genital tract causes pelvic inflammatory disease ( PID), which may be complicated by pelvic abscesses, such as pyosalpinx and tubo-ovarian abscess ( TOA). This study aimed to determine the clinical differences between pyosalpinx and TOA in patients with PID. Material and Methods We retrospectively evaluated 458 female patients who were admitted to Hallym University Kang Dong Sacred Heart Hospital for a clinical diagnosis of PID from 1 January 2007 to 30 April 2012. Sociodemographic, clinical and laboratory data were compared among the non-abscess, pyosalpinx, and TOA groups. Results We identified 110 patients (24%) diagnosed with pelvic abscess associated with PID, including 34 with pyosalpinx and 76 with TOA. The pyosalpinx group had shorter hospital stays ( P = 0.007), lower C-reactive protein levels ( P = 0.015), smaller mass sizes ( P < 0.001), and fewer surgical interventions ( P < 0.001) than the TOA group. Conclusions Pyosalpinx is a less severe form of PID that leads to shorter hospital stays and more favorable outcomes than TOA. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to identify factors that can predict the resistance to parenteral therapy in patients with tubo-ovarian abscesses ( TOA). Material and Methods We conducted a case-control study involving 55 admitted patients with TOA. The subjects eligible for this study included 28 patients who failed antibiotic therapy and required surgery (surgical cases) and 27 patients who were conservatively cured (control cases). The clinical characteristics of the patients on admission were reviewed. Logistic regression analysis was performed after univariate analysis to identify potentially important variables and to calculate odds ratios with 95% confidence intervals. Results As per the univariate analysis, compared to the control cases, the surgical cases were older (40.4 vs 31.5 years), had higher white blood cell counts (14000 vs 11828 cells/mm3), higher C-reactive protein levels (16.1 vs 7.6 mg/dL), and a larger abscess diameter (6.6 vs 3.9 cm). There were no significant differences in gravidity, parity, body temperature, rate of endometrial cyst formation, and Chlamydia trachomatis infection rates between the groups. Multiple logistic regression analysis indicated that the only statistically significant risk factor predicting parenteral antibiotic therapy failure was the abscess diameter >5 cm (odds ratio = 69.6; 95% confidence interval = 9.3-527, P < 0.0001). Conclusion An abscess diameter >5 cm is an important factor for predicting the failure of antibiotic therapy in patients with TOA. Moreover, it is useful for determining whether patients with TOA should be surgically treated. [ABSTRACT FROM AUTHOR]