Pelvic Abscess
Related Subjects:
|Ectopic Pregnancy
| Ovarian Torsion
| Ruptured Ovarian Cyst
| Septic Abortion /Miscarriage
| Pelvic Abscess
| Acute Uterine Haemorrhage
| Pelvic Inflammatory Disease
⚠️ Pelvic abscess is a serious complication of pelvic infection and may result from PID, postpartum infection, or postoperative seeding. Prompt diagnosis and management are critical to prevent sepsis and preserve fertility.
📋 Clinical Presentation
- Lower abdominal/pelvic pain, often unilateral or diffuse.
- Fever, rigors, and malaise; may progress to sepsis if untreated.
- Palpable pelvic mass on bimanual examination.
- History of predisposing factors:
- Pelvic inflammatory disease (PID)
- Postpartum or post-gynecological surgery infection
- Recent abortion or miscarriage
- Systemic signs: tachycardia, hypotension, leukocytosis, raised CRP.
🔬 Investigations
- 🖼 Imaging:
- Pelvic ultrasound → initial investigation; identifies fluid collections and masses.
- CT or MRI → used if US inconclusive or to guide drainage.
- 💉 Laboratory:
- Full blood count → leukocytosis
- Blood cultures → if septic
- CRP/ESR → markers of inflammation
- Endocervical or vaginal swabs → identify causative organisms (chlamydia, gonorrhoea) if PID-related.
⚙️ Management
- Initial Stabilisation:
- IV fluids for hydration and haemodynamic support.
- Analgesia as required.
- Monitor vitals and urine output closely.
- Antibiotic Therapy:
- Empirical broad-spectrum IV antibiotics covering:
- Anaerobes (metronidazole)
- Gram-negative bacilli (e.g., ceftriaxone, cefoxitin)
- Streptococci (ampicillin if indicated)
- Adjust therapy according to culture results.
- Drainage:
- Percutaneous drainage under US or CT guidance preferred if abscess accessible.
- Surgical drainage (laparoscopic or open) if percutaneous approach fails, multi-loculated, or patient deteriorates.
- Supportive Care:
- Monitor haemodynamic status and laboratory parameters.
- Address underlying cause (treat PID, remove foreign body, or manage postoperative infection).
📚 References
