Tubo-Ovarian Abscess after Uterine Artery Embolization for Uterine Fibroid

Aska Toda Kenjiro Sawada

doi:10.4172/2161-0932.1000306

Abstract

Tubo-ovarian abscess is a rare but potentially serious event that can occur after uterine artery embolization (UAE). We describe herein two cases of severe inflammatory tubo-ovarian abscesses. Two women presented with severe abdominal pain, cramping, and fever several months after UAE. Abdominal computed tomography demonstrated an enlarged tubo-ovarian mass, suggestive of an abscess. Percutaneous catheter drainage was performed. In one patient, tubo-ovarian abscess completely disappeared after the drainage, but the other patient eventually required hysterectomy and salpingo-oophorectomy. It is important for clinicians to be aware of tubo-ovarian abscess as a rare complication. Percutaneous drainage might be a useful treatment option.

Highlights

Uterine leiomyomas are the most common solid pelvic tumors in women
uterine artery embolization (UAE) is a frequently performed alternative to surgical intervention for the management of symptomatic uterine fibroids. It is associated with a good success rate in appropriately selected patients, and severe complications such as pelvic infection and death have been reported but are rare [2]
Infectious complications after UAE have been reported in 1% to 2% of cases [4], most of the cases had related uterine infections

Summary

Introduction

Uterine leiomyomas are the most common solid pelvic tumors in women. Since the initial report of Ravina et al [1] in 1995, uterine artery embolization (UAE) has emerged as an effective noninvasive treatment option for women with symptomatic leiomyomas. We report two cases of severe pelvic inflammatory disease complicated by tubo-ovarian abscesses after UAE and required inpatient admission. Because of her persistent symptoms (fever and abdominal pain) and her strong refusal to undergo surgical therapy, CT-guided percutaneous drainage of the right adnexal mass was performed by interventional radiologists and a drainage catheter was placed (Figure 1).

Results

Conclusion