A peri appendicular abscess presenting as tubo ovarian mass

Abstract

An appendicular abscess represents the most prevalent complication associated with acute appendicitis, particularly occurring between the fifth and tenth day after an appendix has perforated. This abscess may manifest in either the retroperitoneal space or the peritoneal cavity. Approximately 8% of patients report epigastric pain, 15% experience generalized abdominal discomfort, while 70% present with localized pain in the periumbilical area. Furthermore, around 95% of individuals exhibit alterations in bowel habits, reduced appetite, nausea, and vomiting. A tubo-ovarian abscess (TOA) refers to an abscess that develops within the uterus, fallopian tubes, and ovaries, and it is a significant concern arising from pelvic inflammatory disease (PID). Not all instances of TOA are associated with PID; infections may also stem from gastrointestinal sources or an ascending vaginal infection. Between 15% and 35% of women treated for confirmed PID are subsequently diagnosed with a TOA. The majority of individuals affected by TOA are within the childbearing age group. Among sexually active women of reproductive age, the estimated lifetime prevalence of self-reported PID is approximately 4.4%. TOAs are generally polymicrobial, with common pathogens including Peptostreptococcus, Bacteroides fragilis, and Escherichia coli.