Tubo-ovarian abscess in pregnancy is extremely rare. Its occurrence increases the maternal and fetal morbidities and mortalities. The clinical presentation is variable ranging from asymptomatic abscess to diffuse peritonitis. In this report, we present a rare case of tubo-ovarian abscess complicating a pregnancy on its 6 weeks and 5 days age of gestation. The patient presented with frank peritonitis. Internal examination revealed uterine, adnexal and cervical tenderness with no masses palpated. A laparotomy was done and intra-operative findings showed an 8 x 4 cm-sized, right, ruptured tubo-ovarian abscess with purulent contamination of the whole pelvic cavity. Right salpingooophorectomy was performed and parenteral antibiotics were given. The pregnancy was eventually carried to term and the patient delivered by repeat low segment cesarean section without fetal and maternal complications.
Pregnancy ; Female ; Abscess ; Oophoritis ; Salpingitis ; Abdominal Abscess

Infertility caused by salpingitis is one of the main causes of secondary infertility in women. In recent years,the incidence has been increasing year by year. Modern medicine believes that this disease is a complication due to incomplete or delayed treatment of acute and chronic salpingitis,with no satisfactory drug therapy at present. Clinical therapies mainly include surgical treatment,interventional treatment and assisted reproductive technology. After summarizing the experience of predecessors and the clinical practice of treating infertility for many years,the author considers that the disease location is the cell veins,and the nature is mostly mixed of deficiency and excess. Kidney deficiency and blood stasis are the main pathogenesis of infertility caused by salpingitis. Blood stasis is the pathological basis,while kidney deficiency is the fundamental pathogenesis. Long-term kidney deficiency will lead to blood stasis,and blood stasis will aggravate kidney deficiency. Both of them are cause and effect to each other. Infertility caused by salpingitis is difficult to cure. Based on the theory of kidney deficiency and blood stasis,the basic principles of clinical treatment are tonifying kidney and activating blood circulation,removing blood stasis and dredging collaterals. Oral administration with traditional Chinese medicine combined with external therapies,such as enema,external application,acupuncture and moxibustion,have been achieved a good efficacy in repairing fallopian tube function and improving pregnancy rate. Therefore,the treatment of infertility caused by salpingitis based on " kidney deficiency and blood stasis" is worthy of further discussion in both clinical and experimental aspects.
Acupuncture Therapy ; Female ; Humans ; Infertility, Female ; Kidney ; Medicine, Chinese Traditional ; Pregnancy ; Salpingitis

OBJECTIVE: This study aimed to identify the predictors for treatment failure of medical management among admitted female patients diagnosed with pelvic inflammatory disease with tubo-ovarian abscess. METHODS: This was a retrospective nested case-control study, using chart review of all cases of pelvic inflammatory disease with tubo-ovarian abscess/complex (N = 49) admitted at the Department of Obstetrics and Gynecology, Philippine General Hospital from January 1, 2014 to December 31, 2018. RESULTS: Medical treatment failure was observed to be significantly higher (51.9%) among patients 40 years old and above as compared to patients less than 40 years old (13.6%). The risk of patients ≥40 years for failed management was 14x higher than those <40 years old (OR=14.00; 95% CI=1.06 to 185.5;p=0.04). The failed management group has significantly higher TOA size of 7.8 (7.8 ± 1.6) as compared to only 5.8 (5.8 ± 1.4) for medical treatment alone group. Correspondingly, those who failed have a significantly bigger volume of 120.4 ml (120.4 ± 84.5) as compared to only 55.2 ml (55.2 ± 40.6) for medical treatment alone group. Other predictive factors such as parity, admitting White blood cell count(WBC), C-Reactive Protein (CRP), and neutrophil-lymphocytic ratio(NLR) were all not significant. CONCLUSION: Tubo-ovarian abscess size of more than or equal to 7 cm, or a volume of more than or equal to 120 ml and advanced age of >40 were all predictive of failed response to medical treatment. Early recognition and intervention whether surgery or drainage may be beneficial to reduce morbidity and long-term sequelae of PID.
C-Reactive Protein ; Pelvic Inflammatory Disease ; Abscess ; Neutrophils ; Oophoritis ; Salpingitis ; Abdominal Abscess ; Lymphocytes

On H1 MRS (magnetic resonance spectroscopy), malignant tumors show higher concentration of metabolite than benign lesions. Lactate double peak was detected in malignant tumor and endometriosis, and more prominent high concentration was demonstrated in endometriosis. Tuboovarian abscesses and salpingitis do not show prominent peak. Dermoid cysts show high levels of lipid peak. Paratubal cyst and follicular cyst can be showed the lipid peak, however, the concentration of lipid is lower than that of dermoid cyst. H1 MRS of ovarian cystic lesions can give valuable information about the presence of metabolites of ovarian cystic lesions.
Abscess ; Dermoid Cyst ; Endometriosis ; Female ; Follicular Cyst ; Lactic Acid ; Magnetic Resonance Spectroscopy* ; Ovarian Cysts ; Ovary ; Parovarian Cyst ; Salpingitis

Genitourinary tuberculosis is a disease spread hematogenously from a small tuberculous abscess of the lung. The renal cortex is initially involved, and multiple granulomas form. Ultimately the cortex may cavitate and communicate with the collecting system, allowing downward extension of the infection and subsequent focal caliectasis with infundibular stenosis, ureteral fibrosis, and calcifications of urinary tract organs. The female genitourinary organ is also infected by the hematogenous spread of tuberculosis, the most common lesion be-ing hydrosalpynx with salpingitis. The clinical and radiologic features of genitourinary tuberculosis may mimic other acute abdominal diseases, and the diagnosis of tuberculosis remains difficult. This report describes the ways in which computed tomography and magnetic resonance imaging are valuable aids in the recognition and diagnosis of genitourinary tuberculosis.
Abscess ; Constriction, Pathologic ; Diagnosis ; Female ; Fibrosis ; Granuloma ; Humans ; Lung ; Magnetic Resonance Imaging ; Salpingitis ; Tuberculosis* ; Ureter ; Urinary Tract

Fitz-Hugh-Curtis syndrome is a condition in which, as a result of pelvic inflammatory disease, the liver capsule becomes involved with inflammatory exudate that later leaves violin string adhesions. Although in the past Neisseria gonorrhea was thought to be the only etiological agent, recent data indicate that Chlamydia trachomatis may play an important role in perihepatitis. Perihepatic adhesions may be an aftereffect of the acute hepatic episode, and because the cause of ectopic pregnancy is thought to be salpingitis, women with an ectopic pregnancy may have a higher prevalence of coexisting perihepatic adhesion. The incidence of this conditon in ectopic gestation was reported to be 14-34 %. Direct observation of the liver and pelvis through laparoscope is the most definitive method of diagnosing salpingitis and perihepatitis. Standard treatement regimens recommended for salpingitis are adequate also for treatement of perihepatitis. We have experienced two cases of Fitz-Hugh-Curtis syndrome associated with ectopic pregnancy, and report with the brief review of the literatures.
Chlamydia trachomatis ; Exudates and Transudates ; Female ; Gonorrhea ; Humans ; Incidence ; Laparoscopes ; Liver ; Neisseria ; Pelvic Inflammatory Disease ; Pelvis ; Pregnancy ; Pregnancy, Ectopic* ; Prevalence ; Salpingitis

Lichen scrofulosorum is a rare disease of children and young adults. The cutaneous lesions of LS are typically symptomless, tiny, flat-topped papular eruptions, which are skin-colored and follicular in distribution. Histopathologically, LS shows perifollicular noncaseating granulomas. LS is usually associated with extrapulmonary tuberculosis, especially of the lymph nodes and bones, and has also been reported in patients with pulmonary tuberculosis. However, the underlying focus is not always obvious, at the time of rash development, and could be diagnosed after the development of LS. Here, we describe a 43-year-old Korean woman with LS who developed tuberculous salpingitis 8 months later.
Adult ; Child ; Exanthema ; Female ; Granuloma ; Humans ; Lichens ; Lymph Nodes ; Rare Diseases ; Salpingitis ; Tuberculosis ; Tuberculosis, Pulmonary ; Young Adult

Most ectopic pregnancies occur in the fallopian tubes. There have been numerous theories to explain the occurrence of ectopic pregnancy in fallopian tubes. The most commonly held view is that the passage of the fertilized ovum through the fallopian tube is delayed or hindered by chronic inflammation and its sequelae. We designed a study to evaluate the details of histopathologic changes and the location of implantation and how they relate to the clinical history. 182 fallopian tube specimens from patients who had undergone total or partial salpingectomy were examined. A high incidence of non-specific inflammation of plicae and wall of tube (31.9%) and salpingitis isthmica nodosa (12.6%) were observed. Other associated findings included acute salpingitis, complex plicae or complex hyperplasia of tubal epithelium, fibrous adhesion with ovary, endometriosis, and calcification. History of previous ectopic tubal pregnancy was found in 8 cases. The cases with serum beta-HCG value above 2,500 I.U./L (group I, n=97) were more frequently noted in those exhibiting myosalpingeal invasion of trophoblast (67 cases) than in those without invasion (30 cases). Of the 182 tubal pregnancies, 117 (64.3%) cases were found in the ampulla and 47 (25.8%) cases in isthmic location. In 117 ampullary pregnancies, the products of conception were found intraluminally in 71 cases (60.7%), and extraluminally in 34 (29.1%) cases, of which the products of conception were found entirely extraluminal. The products of conception, found both within and outside the tubal lumen, were found in 12 cases (10.2%). Of 47 tubes with isthmic pregnancies, 33 cases were intraluminal (70.2%), 12 cases were extraluminal (25.5%), and two cases were mixed (4.3%). In conclusion, significant histopathologic abnormalities accompany a majority of ectopic tubal pregnancy, and myosalpingeal invasion of trophoblast is correlated with high serum beta-HCG. Thus, it is necessary to confirm not only the ectopic placental tissue but also the accompanying details of the other histopathologic findings or the pathologic evaluation of ectopic tubal pregnancy.
Endometriosis ; Epithelium ; Fallopian Tubes ; Female ; Fertilization ; Humans ; Hyperplasia ; Incidence ; Inflammation ; Ovary ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Salpingectomy ; Salpingitis ; Trophoblasts ; Zygote

OBJECTIVE: Mycoplasmas have been implicated in many diseases including cervicitis, urethritis, salpingitis, endometritis... and functioning as cofactors catalyzing the HIV disease state. The oncogenic potentiality of mycoplasma was only recently realized when they were shown causing chromosomal changes and in vitro cell transformations through gradual progressive chromsomal loss and translocation. Few study has been reported the prevalence of mycoplasma infection in human cancers and suggested that there was a connection between these organisms and human cancers. The objective of this study was to determine the relationship between Ureaplasma urealyticum infection and cervical cancer. METHODS: The detection frequency of Ureaplasma urealyticum in 52 invasive cervical cancer tissues and 17 normal cervical tissues was studied using PCR. RESULTS: U. urealyticum DNA was detected in 8 out of 52(15.4%) invasive cervical cancer tissues and 1 out of 17(5.9%) normal cervical tissues. No statistic significance was observed between the detection frequency of Ureaplasma urealyticum and clinicopathologic parameters. The prevalence of Ureaplasma urealyticum in invasive cervical tissues was 15.4% and this rate was higher than 5.9% in normal cervical tissues but there was no statistic significance. CONCLUSIONS: With respect to clinicopathologic parameters of cervical cancer, there was no significant relation between U. urealyticum infection and cervical cancer. There is, however, few study and case on cervical cancer internally and externally. It is considered that more studies on the subject with much cases should be made.
Carcinogenesis ; DNA ; Endometritis ; Female ; HIV ; Humans ; Mycoplasma ; Mycoplasma Infections ; Polymerase Chain Reaction ; Prevalence ; Salpingitis ; Ureaplasma urealyticum* ; Ureaplasma* ; Urethritis ; Uterine Cervical Neoplasms* ; Uterine Cervicitis

The pelvic inflammatory disease (PID) occurs when microbacteria ascend via vagina to the upper genital organs such as endometrium, tubes, ovaries and even pelvic peritoneum as a result of infected intercourse. That could be presented as perihepatitis, parametritis, intraperitoneal pelvic inflammatory disease, not to mention endometritis, salpingitis and tubo-ovarian abscess. Symptoms and signs of PID resembles those of several abdominal diseases such as acute appendicitis, acute gastroenteritis, ectopic pregnancy, and adnexal torsion. Especially differentiation of acute appendicitis from PID is very important because acute appendicitis must be treated by operation but PID could be treated by surgery or antibiotics only even though their symptoms and signs are very alike. So, diagnostic pelviscopy for PID is very important for differential diagnosis and further management. We experienced and report four cases of appendicitis that could not be diagnosed differentially from PID which managed with the emergent pelviscopy successfully.
Abscess ; Animals ; Anti-Bacterial Agents ; Appendicitis ; Diagnosis, Differential ; Endometritis ; Endometrium ; Female ; Gastroenteritis ; Genitalia ; Ovary ; Parametritis ; Pelvic Inflammatory Disease ; Peritoneum ; Pregnancy ; Pregnancy, Ectopic ; Salpingitis ; Vagina