A case of tubo-ovarian abscess 6 years after hysterectomy

Tubo-ovarian abscesses are uncommon complications from pelvic inflammatory disease. The theoretical basis for bacterial seeding of the Fallopian tube and ovary is an ascending infection through the uterus. This paper presents a case of a tubo-ovarian abscess in a woman 6 years after a hysterectomy. Although it is known that tubo-ovarian abscesses can occur in the presence of adjacent appendicitis or diverticulitis, neither of these was present in this patient. Therefore, the mechanism for infection in this patient was either a subacute condition preceding her hysterectomy or hematogenous seeding of her adnexal structures. Either of these mechanisms for infection challenge the currently held theories that have been put forth to describe the formation of tubo-ovarian abscesses.