Computed tomographic features of tuboovarian abscess

OBJECTIVE: To describe the spectrum and frequency of computed tomographic (CT) features in tuboovarian abscess (TOA) in order to increase the utility of computed tomography in diagnosing this condition. STUDY DESIGN: Search of our hospital registry found 22 patients diagnosed with TOA who underwent pelvic tomography between the years 1998 and 2001. A retrospective review of their CT scans was performed, and the CT features of TOA were recorded. Clinical signs and symptoms were also summarized. RESULTS: All 22 patients presented with lower abdominal pain. Additional clinical signs of TOA, such as a palpable abdominal mass (23%), vaginal discharge (27%) and fever (36%), were less common. On tomography the majority of TOAs were unilateral (73%) and multilocular (89%) and had fluid density (95%) and a thick, uniform, enhancing wall (95%). Other common CT findings were thickening of the mesosalpinx (91%) and infiltration into pelvic fat (91%). Less common CT findings included bowel thickening (59%), thickening of the uterosacral ligaments (64%) and pyosalpinx (50%). Ascites, lymphadenopathy, peritoneal involvement and hydronephrosis were uncommon findings on tomography. CONCLUSION: Computed tomography is a useful imaging modality in the diagnosis of TOA, especially in cases that are clinically indeterminate. Recognition of the spectrum of CT findings and their frequency can result in improved CT diagnosis of this disease.