Trends in the management of pelvic abscesses

Mirhashemi, Ramin; Schoell, W; Estape, Ricardo; Angioli, Roberto; Averette, Hervy E.

doi:10.1016/s1072-7515(99)00040-x

Cited by 32 publications

(47 citation statements)

References 27 publications

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“…Surgical intervention is necessary if there is no clinical response at ≥72 h of antibiotic treatment or ruptured abscess. The recurrence rate after antibiotics alone is high and one-third of patients with TOA or pelvic abscess will undergo drainage or surgery [11,12], and this rate would be even higher if the patients who undergo surgery for abscess persistence or recurrence during follow-up were included [11]. Patients who receive conservative therapy alone are likely to necessitate drainage or surgery compared with patients who received antibiotics and image-guided drainage [4].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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Background/Aim: We aimed to assess the value of early laparoscopic therapy in management of tubo-ovarian abscess (TOA) or pelvic abscess. Methods: This was a retrospective study of all consecutive patients who were initially diagnosed with TOA or pelvic abscess at the local hospital between January 2010 and December 2014. The risks of operation and recurrence were analyzed using logistic analyses. Results: The durations of body temperature > 38.0°C (p = 0.001) and hospitalization (p < 0.001) were longer in the conventional group versus the early laparoscopy group. In the conventional group, 15 (50%) patients finally underwent laparoscopic exploration. The abscess size in the late laparoscopic group was significantly larger than the successful antibiotic treatment group (6.3 ± 1.5 vs. 4.9 ± 1.2 cm, p = 0.010). Abscess > 5.5 cm was independently associated with antibiotic failure (OR 4.571; 95% CI 1.612–12.962). Compared with late laparoscopy, early laparoscopy was associated with a shorter operation time (p = 0.037), less blood loss (p = 0.035), and shorter durations of body temperature > 38.0°C (p < 0.001) and hospitalization (p < 0.001). The cost was the lowest in the patients successfully treated conservatively. Conclusion: Early laparoscopic treatment is associated with shorter time of fever resolution, shorter hospitalization, and less blood loss compared with conventional treatment for TOA or pelvic abscess.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Chu

Liang

et al. 2019

Gynecol Obstet Invest

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“…The response rate to antimicrobial treatment alone is about 70%. Failure of treatment is characterized by increase in the size of the TOA, persistently elevated temperature or signs of peritonitis 2 . There is a high recurrence rate for TOAs after treatment with antibiotics alone, requiring repeat hospital admissions in many cases.…”

Section: Introductionmentioning

confidence: 99%

Comparison of CT‐ or ultrasound‐guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo‐ovarian abscesses

Goharkhay

Verma

Maggiorotto

2006

Ultrasound in Obstet & Gyne

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“…The fluid may be present as free or in the shape of a pelvic peritoneal inclusion cyst in the cul-de-sac, with thin adhesions between the different organs in the pelvis, without tenderness with touch of the vaginal probe or clinical signs and symptoms of an acute illness [34]. CT scanning can be used, especially during the acute presentation when the diagnosis may be unclear and other intraabdominal pathology may be suspected [35,36].…”

Section: Adnexal Mass In Pregnancymentioning

confidence: 99%

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

Zucchini¹,

Marra²

2014

J Ultrasound

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Several surgical and/or medical emergencies/ urgencies may occur in gynecologic patients and in pregnant women during the first trimester. Particularly, ectopic pregnancies, ruptured or hemorrhagic ovarian cysts, ovarian or adnexal torsions, threatened or inevitable miscarriages, phlogistic gynecological disorders, complications involving the uterine fibroids, endometriosis, and spontaneous uterine rupture are possible acute complications. The diagnosis is suspected on the basis of symptoms (acute pelvic and/or abdominal pain, with or without vaginal bleeding or discharge, until acute abdomen with peritonitis), by means physical evaluation (abdominal, pelvic, and bimanual gynecological examinations), by means of transabdominal (TAS) and/or transvaginal (TVS) sonography, and laboratory tests. However, the diagnosis is often not that simple, especially when the symptoms and clinical signs are minimal, and ultrasound (US) examination is not diriment. The differential diagnosis of abdominal/pelvic pain is broad and includes primarily gastrointestinal and urogenital disorders. Generally, TAS should usually be used in conjunction with TVS for evaluation of the female pelvis. If the US examination is not conclusive, CT or MRI, especially in pregnant patients, should be considered.Riassunto Diverse emergenze/urgenze chirurgiche e/o mediche possono interessare le pazienti ginecologiche e le gravide al primo trimestre. In particolare, le gravidanze ectopiche, le cisti ovariche rotte o torte, le torsioni ovariche o annessiali, le minacce d'aborto o gli aborti inevitabili, le patologie infiammatorie ginecologiche, i fibromi uterini complicati, l'endometriosi e la rottura uterina spontanea rappresentano possibili complicanze acute. La diagnosi può essere sospettata in base alla sintomatologia (algie pelviche e/o addominali acute, con eventuali perdite vaginali, fino a un quadro di addome acuto con peritonite), alla visita (valutazione addominale, pelvica ed esplorazione ginecologica bimanuale), all'ecografia transaddominale (TAS) e/o transvaginale (TVS), e agli esami di laboratorio. Tuttavia, la diagnosi spesso non è semplice, soprattutto quando i sintomi e i segni clinici sono lievi e l'ecografia non è dirimente. La diagnosi differenziale del dolore addominale/ pelvico comprende un'ampia varietà di disordini, in particolare gastrointestinali e urogenitali. Generalmente, la valutazione della pelvi femminile dovrebbe essere eseguita mediante ecografia sia transaddominale che transvaginale. Se l'esame ecografico non consente di fare diagnosi, dovrebbero essere presi in considerazione la TC o, specialmente nelle donne gravide, la RMI.

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Trends in the management of pelvic abscesses

Cited by 32 publications

References 27 publications

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Effectiveness and Adverse Events of Early Laparoscopic Therapy versus Conservative Treatment for Tubo-Ovarian or Pelvic Abscess: A Single-Center Retrospective Cohort Study

Comparison of CT‐ or ultrasound‐guided drainage with concomitant intravenous antibiotics vs. intravenous antibiotics alone in the management of tubo‐ovarian abscesses

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

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