Tubo-Ovarian Abscess (TOA)

Question 1

TOA is regarded as a complication of

Answer 1

PID

Question 2

cxfx

Answer 2

cervical motion tenderness, acute lower abdominal pain, fever, and chills

Question 3

Suspect a

ruptured TOA if the patient also has

Answer 3

hypotension, tachycardia, tachypnea, and acute peritoneal signs (abdominal tenderness, rebound, rigidity, guarding)

Question 4

TOAs are usually __and

often contain a mixture of ___

Answer 4

polymicrobial

aerobic, facultative, and anaerobic bacteria.

Question 5

Workup includes

Answer 5

CBC and culture for gonorrhea/chlamydia

Question 6

Best initial imaging test is

Answer 6

a transvaginal ultrasound showing a complex, multilocular mass.

Question 7

CT scan is preferred if ____must also be excluded;

Answer 7

bowel pathology

Question 8

CT reveals

Answer 8

a thick-walled, rim-enhancing adnexal mass

Question 9

Treatment

Answer 9

IV antibiotics: cefoxitin and doxycycline (or in penicillin-allergic patients: clindamycin and gentamicin).

Question 10

Ruptured TOA management

Answer 10

qx emergency

Question 11

Patients who do not improve with antibiotics alone in___hours or whose abscess is large (__) should have image-guided percutaneous drainage.

Answer 11

48–72

> 9 cm