Comprehensive Clinical Evaluation, Diagnostic Imaging, and Multidisciplinary Management of Tubo-Ovarian Abscess: Implications for Family Medicine, Nursing Care, and Radiologic Practice
Abstract
Background: A tubo-ovarian abscess (TOA) is a severe complication of pelvic inflammatory disease (PID), characterized by a purulent collection involving the fallopian tube and ovary. It poses significant risks of morbidity, infertility, chronic pelvic pain, and life-threatening sepsis if not managed promptly.
Aim: This article provides a comprehensive clinical evaluation of TOA, detailing its etiology, risk factors, pathophysiology, and diagnostic approach. It aims to outline evidence-based, multidisciplinary management strategies involving family medicine, nursing, radiology, and gynecology to optimize patient outcomes and preserve reproductive potential.
Methods: The review synthesizes current clinical guidelines and literature on TOA management. Diagnosis relies on a combination of patient history, physical examination (e.g., cervical motion tenderness, adnexal mass), laboratory tests (e.g., leukocytosis, elevated inflammatory markers, STI testing), and imaging, primarily transvaginal ultrasonography and computed tomography.
Results: Initial management with broad-spectrum intravenous antibiotics is successful in 70-87% of cases. For larger abscesses (>5.5 cm) or those not responding to antibiotics within 72 hours, image-guided drainage or surgical intervention (laparoscopy/laparotomy) is required. Multidisciplinary care is critical for success, improving survival and fertility outcomes.
Conclusion: TOA is a serious gynecologic emergency whose prognosis depends on early diagnosis and a tailored, multidisciplinary approach. Timely antibiotic therapy, coupled with appropriate drainage or surgery when indicated, is essential to reduce acute morbidity and preserve long-term reproductive health.
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Authors
Copyright (c) 2024 Khaled Alnashmi F Alanazi, Yasser Said Alzahrani , Ahmed Ibrahim Ibrahim Jarrah, Haya Saad Said Aldossari, Nodaha Mubarak Hamdan Al-Dosari, Azzah Atitallah Ali Alzahrani, Amira Nasser Aljaber, Mohammad Abdullah Mubarak Almarwan, Mohammed Yahya Abdu Rayyani, Thikrayat Mohammed Alaithan, Fahad Sulaiman Almousa, Fozeh Menhy Alrewily, Albandari Sulaiman A Al Nafisah
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