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de Labaig A, Guzmán Muñoz M, García Sánchez F, Menéndez Fuster J. Actinomicosis: dos casos clínicos ginecológicos. ¡No sólo los DIUs tienen la culpa! CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2022.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abdominopelvic Actinomycosis—The Diagnostic and Therapeutic Challenge of the Most Misdiagnosed Disease. Life (Basel) 2022; 12:life12030447. [PMID: 35330198 PMCID: PMC8954618 DOI: 10.3390/life12030447] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Abdominopelvic actinomycosis is a rare chronic or subacute bacterial infection caused by Actinomyces israelii, a Gram-positive anaerobic bacterium that normally colonizes the digestive and genital tracts, clinically presented as an inflammatory mass or abscess formation. Methods: We reviewed the medical records of the patients from our clinic with abdominopelvic actinomycosis who underwent surgery between 2002 and 2022. In this period, 28 cases (9 men and 19 women) were treated. The mean age was 43.36 years and they were hospitalized for abdominopelvic tumors or inflammatory tumors in 15 cases and inflammatory disease in 13 cases. Results: Causes of actinomycosis in the studied group were an intra-uterine contraceptive device in 17 cases, foreign bodies in 2 cases, diabetes in 4 cases, stenting of the bile duct in 1 case, and immunodepression. For 6 patients, we performed surgery by open approach and for 21 patients by a laparoscopic approach. For nine patients, abdominopelvic actinomycosis had been mimicking a colon malignancy (cecum and ascending colon, four cases; transverse colon, two cases; and on the greater omentum, three cases) and for six patients, a pelvic tumor (advanced ovarian cancer). After surgery the patients underwent specific treatment with antibiotics, with good results. In two cases we discovered and treated hepatic actinomycosis, one case by a laparoscopic approach and one case by a percutaneous approach. In our lot we noticed three recurrences that required reintervention in patients who had had short-term antibiotics due to non-compliance with treatment out of four such cases. Conclusions: For abdominopelvic malignancies, actinomycosis should be included in the differential diagnosis, as well as for inflammatory bowel diseases and bowel obstructions. We have a wide range of patients considering the rarity of this condition. Long-term antibiotics are necessary to prevent recurrence.
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Nepal P, Ojili V, Kumar S, Kumar D, Nagar A. Imaging spectrum of common and rare infections affecting the lower genitourinary tract. Abdom Radiol (NY) 2021; 46:2665-2682. [PMID: 33388810 DOI: 10.1007/s00261-020-02889-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
In this review, we will discuss the imaging findings of common as well as uncommon lower genitourinary tract infections. For both clinicians and radiologists, it is imperative to understand etiopathogenesis, epidemiological information, clinical presentation, imaging findings and management options of such conditions. Knowledge of salient imaging features of these infections is of utmost importance because prompt recognition enables appropriate management.
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Odetto D, Perrotta M, Saadi JM, Chacon CB, Causa Andrieu PI, Wernicke A, Saez Perrotta MC. Infection versus cancer: management of actinomyces mimicking cervical cancer or ovarian cancer. Int J Gynecol Cancer 2020; 30:1638-1643. [PMID: 32753563 DOI: 10.1136/ijgc-2020-001800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Diego Odetto
- Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Myriam Perrotta
- Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Jose Martin Saadi
- Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Pamela Ines Causa Andrieu
- Radiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.,Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alejandra Wernicke
- Department of Pathology, Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina
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Carrara J, Hervy B, Dabi Y, Illac C, Haddad B, Skalli D, Miailhe G, Vidal F, Touboul C, Vaysse C. Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis. J Clin Med 2020; 9:jcm9030821. [PMID: 32197366 PMCID: PMC7141382 DOI: 10.3390/jcm9030821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 12/02/2022] Open
Abstract
The particularity of pelvic actinomycosis lies in the difficulty of establishing the diagnosis prior to treatment. The objective of this retrospective bicentric study was to evaluate the pertinence and efficacy of the different diagnostic tools used pre- and post-treatment in a cohort of patients with pelvic actinomycosis. The following data were collected: clinical, paraclinical, type of treatment, and the outcome and pertinence of the two diagnostic methods, bacteriological or histopathological, were evaluated. Twenty-seven women were included, with a pre-treatment diagnosis proposed for 66.7% (n = 18) of them. The diagnosis was established in 13.6% (n = 3) of cases through bacteriological samples, and in 93.8% (n = 15) of cases through histopathological samples, with endometrial biopsy positive in 100% of cases. The treatment was surgical with antibiotics for 55.6% (n = 15) of patients, medical with antibiotic therapy for 40.7% (n = 11) of patients, and surgical without antibiotics for one patient. All patients achieved recovery without recurrence, with a median follow-up of 96 days (4–4339 days). Our study suggested an excellent performance of histopathological analysis, and in particular endometrial biopsy, in the diagnosis of pelvic actinomycosis. This tool allowed early diagnosis and, in some cases, the use of antibiotic therapy alone, making it possible to avoid surgery.
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Affiliation(s)
- Julie Carrara
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Blandine Hervy
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
| | - Yohann Dabi
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Claire Illac
- Service d’Anatomie-Pathologie, Université de Toulouse, CHU de Toulouse, 31059 Toulouse, France;
| | - Bassam Haddad
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Dounia Skalli
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Gregoire Miailhe
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Fabien Vidal
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
| | - Cyril Touboul
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Charlotte Vaysse
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
- Correspondence: ; Tel.: +33-5-6132-2828; Fax: +33-5-3115-5318
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Serfaty D, Bénézech JP, Heckel S, De Reilhac P. Consensus of best practice in intrauterine contraception in France. EUR J CONTRACEP REPR 2019; 24:305-313. [PMID: 31204843 DOI: 10.1080/13625187.2019.1625325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: Our aim was to provide a consensus of best practice in intrauterine contraception (IUC) for French practitioners. Methods: A meeting of 38 gynaecologists was held to establish a consensus of best practice in IUC, using the validated nominal group (NG) method to reach consensus. Seventy questions were posed covering insertion, monitoring and removal of IUC devices. Two working groups were formed and all proposals were voted on, discussed and approved by the NG. Results: Of the 70 questions asked, answers to only four failed to reach NG consensus. While, in general, the IUC practices of French gynaecologists are in line with international guidelines, some notable differences were identified: for example, when to use the levonorgestrel-releasing intrauterine system versus the copper intrauterine device; practice recommendations in the event of upper genital tract infections; and immediate postpartum insertion. Clinicians are encouraged to inform women about IUC, irrespective of their age or parity. In general, the wishes and characteristics of the woman must be the main criteria informing the choice of IUC, once all potential contraindications have been excluded and information about IUC shared. Conclusions: This consensus paper is intended to update and standardise knowledge about IUC for health care professionals, to address any reticence about use of this contraceptive method.
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Affiliation(s)
| | | | - Sergine Heckel
- c Obstetrician Gynaecologist , Centre hospitalier Saint-Joseph et Saint-Luc , Lyon , France
| | - Pia De Reilhac
- d Obstetrician Gynaecologist , Place Paul Emile Ladmirault , Nantes , France
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[Pelvic actinomycosis: Diagnostic and therapeutic aspects]. ACTA ACUST UNITED AC 2016; 44:168-74. [PMID: 26857044 DOI: 10.1016/j.gyobfe.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 11/26/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Actinomycosis is a rare little known granulomatous suppurative disease, more common in women, aided by the use of contraceptive purposes intrauterine device (IUD). Pelvic location is the rarest with an extension to adjacent organs making preoperative diagnosis difficult and misleading clinical presentation. Early diagnosis of this affection determines the therapeutic strategy and avoids mutilating interventions especially in young women. METHODS We reviewed the record of women who consulted the department of obstetrics and gynecology at Ben Arous hospital (Tunisia) between January 2003 and December 2013 for a pelvic pain syndrome and in whom diagnosis of actinomycosis was suspected by clinical and imaging and confirmed by pathology. RESULTS Eight cases of gynecologic abdominopelvic actinomycosis were diagnosed during the study period. Seven patients were carriers of an intrauterine device, with an average duration of 5 years wearing. Functional signs were essentially pelvic pain and fever. Physical examination of patients mainly showed two clinical presentations: a pelvic tumor syndrome or abdominopelvic and an array of pelvic abscess or pelvic inflammatory disease. Radiological investigations were allowed to suspect the diagnosis of actinomycosis only in one patient, in whom percutaneous biopsy confirmed the histological diagnosis without resorting to a surgical procedure. Operative procedures performed were varied as appropriate. The diagnosis of actinomycosis was made by pathology without any cases of bacterial isolation. All patients received antibiotic treatment with penicillin. The subsequent evolution was favorable. CONCLUSION The diagnosis of actinomycosis should be considered in any invasive abdominal mass of neoplastic appearance and in case of table of genital infection especially in patients bearing IUD for 5 years or more.
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Boyanova L, Kolarov R, Mateva L, Markovska R, Mitov I. Actinomycosis: a frequently forgotten disease. Future Microbiol 2016; 10:613-28. [PMID: 25865197 DOI: 10.2217/fmb.14.130] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Actinomycosis is a rare subacute or chronic, endogenous infection mainly by Actinomyces species, showing low virulence through fimbriae and biofilms. Cervicofacial, thoracic, abdominal, pelvic and sometimes cerebral, laryngeal, urinary and other regions can be affected. Actinomycosis mimics other diseases, often malignancy. Disease risk in immunocompromised subjects needs clarification. Diagnosis is often delayed and 'sulfur granules' are helpful but nonspecific. Culture requires immediate specimen transport and prolonged anaerobic incubation. Imaging, histology, cytology, matrix-assisted laser desorption ionization time-of-flight mass spectrometry and molecular methods improve the diagnosis. Actinomycetes are β-lactam susceptible, occasionally resistant. Treatment includes surgery and/or long-term parenteral then oral antibiotics, but some 1-4-week regimens or oral therapy alone were curative. For prophylaxis, oral hygiene and regular intrauterine device replacement are important.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Bulgaria
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Laios A, Terekh I, Majd HS, Pathiraja P, Manek S, Haldar K. Differentiating pelvic actinomycosis from advanced ovarian cancer: a report of two cases, management reflections and literature review. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2014; 1:5. [PMID: 27231558 PMCID: PMC4877746 DOI: 10.1186/2053-6844-1-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/02/2014] [Indexed: 11/18/2022]
Abstract
Pelvic actinomycosis comprises a rare, subacute to chronic bacterial infection characterised by suppurative and granulomatous inflammation. Diagnosis is difficult as it may simulate pelvic malignancies. Laboratory and radiological findings are non-specific. We reported on 2 cases of pelvic actinomycosis mimicking ovarian malignancy with different management approaches that lead to opposite outcomes. We reviewed the literature on pelvic actinomycosis imitating ovarian cancer with a focus on its surgical management. Despite agreement on the duration of antibiotic therapy following surgical management, consensus regarding surgical approach was rather equivocal. We concluded that pelvic actinomycosis should be strongly suspected in women with presumed ovarian cancer of atypical presentation and a history of intrauterine devices (IUD).
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Affiliation(s)
- Alex Laios
- Gynaecologic Oncology Unit, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Iryna Terekh
- Gynaecologic Oncology Unit, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Hooman Soleymani Majd
- Gynaecologic Oncology Unit, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Pubudu Pathiraja
- Gynaecologic Oncology Unit, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Sanjiv Manek
- Department of Cellular Pathology, Oxford University Hospitals, Oxford, UK
| | - Krishnayan Haldar
- Gynaecologic Oncology Unit, Churchill Hospital, Oxford University Hospitals, NHS Trust, Oxford, UK
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Intrauterine device may trigger typical attacks of familial Mediterranean fever: a case report. Wien Klin Wochenschr 2014; 127:68-70. [PMID: 25398289 DOI: 10.1007/s00508-014-0631-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by episodic, recurrent, self-limited attacks of fever and serositis (sterile peritonitis, pleuritis, arthritis, etc). The insufficiency in restriction of mild inflammation contributes this consequence in FMF.Intrauterine devices (IUDs) have been widely used in the world for contraception by gynecologists as an effective and safe method. Herein, we present a woman with FMF as the first case, whose attacks were triggered by copper-containing IUD. Our hypothesis in the present case was that sterile mild inflammation in the uterus caused by copper-containing IUD may be the initial source of systemic inflammatory response.In our opinion, clinicians should consider that the copper-containing IUDs may be another cause of FMF attacks in women using this contraceptive method.
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Smid MC, Bhardwaj NR, Di Giovanni LM, Eggener S, Torre MD. Renal hemorrhagic actinomycotic abscess in pregnancy. Infect Dis Rep 2014; 6:5157. [PMID: 24757509 PMCID: PMC3987246 DOI: 10.4081/idr.2014.5157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/29/2014] [Accepted: 02/04/2014] [Indexed: 11/23/2022] Open
Abstract
Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.
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Affiliation(s)
- Marcela C Smid
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina at Chapel Hill School of Medicine , NC, USA ; Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Neha R Bhardwaj
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Laura M Di Giovanni
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Scott Eggener
- Section of Urology, University of Chicago Medicine , IL, USA
| | - Micaela Della Torre
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
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Ertas IE, Gungorduk K, Ozdemir A, Emirdar V, Gokcu M, Dogan A, Solmaz U, Yildirim Y. Pelvic tuberculosis, echinococcosis, and actinomycosis: Great imitators of ovarian cancer. Aust N Z J Obstet Gynaecol 2014; 54:166-71. [DOI: 10.1111/ajo.12191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 01/09/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Ibrahim E. Ertas
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Kemal Gungorduk
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Aykut Ozdemir
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Volkan Emirdar
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Mehmet Gokcu
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Askin Dogan
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Ulas Solmaz
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
| | - Yusuf Yildirim
- Department of Gynaecologic Oncology; Tepecik Education and Research Hospital; Izmir Turkey
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Triantopoulou C, der Molen AV, Es ACMGV, Giannila M. Abdominopelvic actinomycosis: spectrum of imaging findings and common mimickers. Acta Radiol Short Rep 2014; 3:2047981614524570. [PMID: 24778807 PMCID: PMC4001438 DOI: 10.1177/2047981614524570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 12/09/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Actinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult. PURPOSE To describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases. MATERIAL AND METHODS In our study we analyzed 18 patients (15 women, 3 men; age range, 25-75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT. RESULTS The sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination. CONCLUSION Actinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation.
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Affiliation(s)
| | | | - Ad CMG Van Es
- Radiology Department, Leiden University Medical Center, the Netherlands
| | - Maria Giannila
- Radiology Department, Konstantopouleio General Hospital, Athens, Greece
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Actinomycose secondaire du psoas : une complication du dispositif intra-utérin. ACTA ACUST UNITED AC 2013; 41:190-2. [DOI: 10.1016/j.gyobfe.2012.09.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 10/26/2011] [Indexed: 11/19/2022]
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Abstract
The antibiotic treatment is indispensable for the treatment of the tubo-ovarian abscesses (TOA). It has to have a wide spectre and would be secondarily adapted in case of a sexually transmitted infection. The surgery remains indicated in first intention in case of vital threat (generalized peritonitis, toxic shock). In the not complicated TOA, the evacuation of abscesses (by draining under imaging or laparoscopy) with the antibiotic treatment gives better rates of cure than the antibiotic treatment alone. For the surgery, several entrys are possible. The laparoscopy allows a shorter hospitalization with fewer complications and a faster resolution of the fever than the laparotomy. The conservative surgery, realized by laparoscopy, has hight rates of successes with few complications. The radical surgery, by coelioscopy or by laparotomy, has high rates of complications. Transvaginal ultrasound guided aspiration is an alternative in the drainage by laparscopy with identical succes. It has been well evaluated. It has low morbidity and can be proposed in first intention in not complicated TOA.
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