TOA (Tubo-Ovarian Abscess)

Think beyond PID as a sole risk factor: look for a history of infertility treatments and pelvic surgery - Alex Koyfman MD

TOA (Tubo-Ovarian Abscess)
TOA (Tubo-Ovarian Abscess)

image by: Clinica Medica Santa Fe

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Tubo-ovarian Abscess: Pearls & Pitfalls

While TOA was once more commonly associated with being life-threatening, advancements in antibiotics and surgical techniques have resulted in a near absent mortality. However, failure to recognize it can result in irreversible tubal and ovarian damage, chronic pelvic pain, adhesion formation, ectopic pregnancy, and abscess rupture...

While the differential list is long and can span across the reproductive system, gastrointestinal tract, and urinary tract, key differentials to keep in mind in the ED are ectopic pregnancy, PID, ovarian torsion, appendicitis, and incarcerated hernia.

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Resources

  Tubo-ovarian Abscess: Pearls & Pitfalls

Tubo-ovarian abscess is an inflammatory mass involving the fallopian tube, ovary, or adjacent pelvic organs. When there is an agglutination of these structures, it is called a tubo-ovarian complex.

International Emergency Medicine Education Project

Tubo-ovarian abscess (TOA) is a walled-off infection of adnexal structures, typically the fallopian tubes or ovary and occasionally adjacent intra-abdominal structures. It is a potentially life-threatening progression of the pelvic inflammatory disease (PID).

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