Ovarian abscess

Description:

In the beginning the sizes of abscess are insignificant, but at the same time there are reactive changes from the bodies surrounding it and a peritoneum therefore the conglomerate into which structure, except an ovary, the pipe, a corner of a uterus and even an epiploon and adjacent sites of a gut can enter is formed.
At increase of an inflammation there is an abscess merging with similar abscesses and reaching sometimes the big sizes. Ovary abscesses preferential unilateral.
In cases of a virulent infection and weakening of an organism, abscess extends in depth of an ovary which represents a purulent bag, and when progressing process in an ovary and a pipe the partition dividing them melts therefore both purulent cavities merge, forming the tubo-ovarian abscess reaching sometimes the considerable sizes. In most cases the acute inflammation passes in chronic - an oophoritis.

Symptoms of Ovarian abscess:

Abscesses of an ovary are observed: at women of any age, but most often they arise during the reproductive period. Operations on bodies of a small pelvis are the contributing factor, and symptoms of abscess appear usually for the 3-17th day after operation.

Usually first and constantly present at all patients symptom - abdominal pains. They are described most often as rather weak and aching in the beginning, and then sharply amplifying. At some patients severe, acute pains at once begin. Their sharp strengthening usually serves as an indicator of the imminent rupture of abscess. The pelvic pains arising after operation can be caused only by it, however postoperative pains amplify, and on the contrary, considerably decrease or disappear in 3-4 days.

Other symptoms are expressed minimum. It is possible to note oznoba, an indisposition and loss of appetite. Nausea and vomiting are not characteristic, except for cases of development of peritonitis.

The most constant objective sign observed at patients with ovary abscess is fever, temperature sometimes rises to 41 C. Normal temperature can be observed at patients with the chronic course of process or septic shock. Fever usually is followed by tachycardia which at septic patients is a sign of a vascular collapse.

The research of a stomach yields very different results that depends on degree of manifestation of infectious process. At initial stages of a disease the morbidity which is localized in one of the lower quadrants of a stomach is usually observed. The peristaltics of intestines remains, however eventually symptoms of peritonitis appear. Limited peritonitis is shown by morbidity in the lower quadrants of a stomach, symptoms of irritation of a peritoneum and muscle tension of an abdominal wall. At a rupture of abscess and diffuse peritonitis the similar phenomena, but expressed on all stomach are noted. Tumorous education is sometimes palpated.

The research of bodies of a small pelvis after a hysterectomy can reveal morbidity and an induration of a stump of a vagina. Painful tumorous education in a cavity of a small pelvis is palpated more than at 60% of women. At other patients tumorous education happens the small size or carrying out a research is complicated in connection with the expressed stomach muscle tension. Cystous character and the sizes from 3 to 15 cm in the diameter has education. More often abscesses arise on the right side and can be located in upper parts of a small pelvis about its sidewall or adjoin a vagina stump if they appear after a hysterectomy.

Reasons of Ovarian abscess:

In most cases arises owing to a purulent inflammation of uterine tubes, most often - in the period of a rupture of a follicle or a yellow body.

Treatment of Ovarian abscess:

Abscesses of an ovary treat by means of antibiotics and surgical drainage. Conservative treatment only by one antibiotics in this case is contraindicated as there is a high risk of opening of abscess in an abdominal cavity and respectively - death.

Treatment of abscess of an ovary antibiotics has to be directed first of all against the flora which is the most often sowed from a genital tract. Purpose of penicillin, gentamycin, and also chloramphenicol or clindamycin is quite acceptable.

The trial laparotomy is the best action for drainage of an abdominal cavity or removal of abscess of an ovary. In the latter case usually delete the struck appendages as most often this disease unilateral and arises after a hysterectomy. The decision concerning removal of a uterus or contralateral appendages is accepted strictly individually and is based on data of a laparotomy. However, sometimes the data which are definitely indicating the need of performance of this or that volume of operation do not manage to be received.