26 - TOA (Tubo-Ovarian Abscess): Three letters you don’t want to hear

Abstract

Tubo-ovarian abscess (TOA) is often the result of pelvic inflammatory disease (PID), but there is a significant portion of patients who have TOA without PID and are not sexually active. Because an inflammatory mass is required for the diagnosis of TOA, imaging plays a role in these patients. Ultrasound is the initial imaging modality in the majority of patients with concern for an ovarian process, such as TOA. Advanced imaging techniques, such as computed tomography and magnetic resonance imaging, can also detect a TOA but are used as secondary studies when sonography is equivocal, the disease process is complex, or other etiologies are being considered, such as appendicitis.