de la Cruz-Cámara RA, Vidal-Graniel DE, Córdova-Méndez F, Martínez-Hernández CM

Language: Spanish
References: 12
Page: 903-907
PDF size: 247.82 Kb.

ABSTRACT

Background: Tubo-ovarian abscess as part of pelvic inflammatory disease has different characteristics in postmenopausal patients than in younger women.
Clinical case: A 68-year-old woman with a history of five pregnancies, three deliveries and two caesarean sections, with an active sexual life, type 2 diabetes mellitus and chronic arterial hypertension under control. She presented with severe pain in the left iliac fossa with radiation to the right iliac fossa, accompanied by vomiting, which reduced the prescribed intake of non-steroidal anti-inflammatory drugs and antibiotics. Based on the clinical and imaging findings, an exploratory laparotomy was performed, which revealed the following: multiseptal pelvic abscess originating from the right adnexa with drainage of 250 cc of purulent material. There were also findings of: severe adhesive syndrome, mesenteric adenitis, involvement of the cecal appendix with reactive inflammatory processes, and sigmoid colon depulpation with bleeding of 500 cc.
Conclusions: Pelvic inflammatory disease associated with a tubo-ovarian abscess in a postmenopausal patient is uncommon, perhaps because of this it is sometimes underdiagnosed, leading to increased morbidity and mortality.

REFERENCES

1. Savaris RF, Fuhrich DG, Maissiat J, Duarte RV, et al.Antibiotic therapy for pelvic inflammatory disease. CochraneDatabase Syst Rev 2020; 8 (8): CD010285. doi:10.1002/14651858.CD010285.pub3

2. Curry A, Williams T, Penny ML. Pelvic inflammatory disease:diagnosis, management, and prevention. Am Fam Physician2019; 100 (6): 357-.64.

3. Hillier SL, Bernstein KT, Aral S. A review of the challengesand complexities in the diagnosis, etiology, epidemiology,and pathogenesis of pelvic inflammatory disease. J InfectDis 2021; 224 (12 Suppl 2): S23-S28. doi: 10.1093/infdis/jiab116

4. Granero R, Garrido JI, Vázquez F, Vargas V, Ruiz C, ParedesRM. Abdomen agudo como presentación de abscesotuboovárico en adolescente totalmente inactiva. ProgObstet Ginecol 2012; 55 (9): 441-44. doi:10.1016/j.pog.2012.04.005

5. Ford GW, Decker CF. Pelvic inflammatory disease. Dis Mon2016; 62 (8): 301-5. doi:10.1016/j.disamonth.2016.03.015

6. Saona Ugarte P. Enfermedad pélvica inflamatoria: diagnósticoy complicaciones. Rev Per Ginecol Obste 2015; 3 (4):234-39. https://doi.org/10.31403/rpgo.v53i1048

7. Santana MA, Suárez B, Ocón L, Seara S. Diagnóstico ytratamiento de la enfermedad pélvica inflamatoria. ClinInvest Ginecol Obstet 2018; 45: 157-62. doi:10.1016/j.gine.2017.04.0018

8. Darville T. Pelvic inflammatory disease due to Neisseriagonorrhoeae and Chlamydia trachomatis: Immune evasionmechanisms and pathogenic disease pathways. J Infect Dis2021; 224 (12 Suppl 2): S39-S46. doi:10.1093/infdis/jiab031

9. Rivera C, Pomés C, Díaz V, Espinoza P, et al. Actualización delenfrentamiento y manejo del embarazo ectópico tubario.Rev chil obstet ginecol 2020; 85 (6): 697-708. http://dx.doi.org/10.4067/S0717-75262020000600697

10. Menezes MLB, Giraldo PC, Linhares IM, Boldrini NAT, et al.Brazilian protocol for sexually transmitted infections 2020:pelvic inflammatory disease. Epidemiol Serv Saude 2021;30 (1): e2020602. doi:10.1590/S1679-4974202100011.esp1

11. Álvarez-Pabón Y, Sepúlveda-Agudelo J, Díaz- Martínez LA.Enfermedad pélvica inflamatoria: análisis retrospectivo.Ginecol Obstet Mex 2017; 85 (7): 433-41. https://ginecologiayobstetricia.org.mx/articulo/enfermedad-pelvicainflamatoria-analisis-retrospectivo

12. Córdova CA, Baquerizo AF, Roca CA, Almeida KA. Enfermedadinflamatoria pélvica. Recimundo 2022; 6(3): 30-https://doi.org/10.26820/recimundo/6.(3).junio.2022.30-36