Tubo-ovarian abscess in an emergency department: clinical presentation, diagnosis, and treatment

Abstract

Objective: To analyze the clinical features, related diagnostic tools, management, and outcomes of patients with tubo-ovarian abscess (TOA). Study Design: The authors conducted a retrospective review of 74 patients with TOA, admitted to an emergency department (ED) during a four-year period. They collected clinical data, hospital course records, and outcomes information of each patient. They also compared the differences in various characteristics between patients who had undergone operative and non-operative treatments. Results: The patient age range was 15–60 years, and most patients were in their 30s and 40s. Most patients presented with leukocytosis and elevated levels of C-reactive protein in their ED visit. The sizes of the TOA (determined through transvaginal ultrasound examinations) were consistent with those determined through CT. The operative group exhibited higher white cell counts and larger abscesses than did the non-operative group. Conclusion: In Taiwan, patients with TOA are older than those in Western countries. The leukocyte count and C-reactive protein level can serve as screening tests, and both transvaginal ultrasound examination and CT show excellent diagnostic accuracy. Patients with elevated leukocyte counts and large abscesses are more likely to require surgical intervention.