Simple Technique for Transvaginal Aspiration of a Tubo-Ovarian Abscess

Large tubo-ovarian abscesses (TOAs) usually require drainage or operative management in addition to antibiotics. All previous reports of transvaginal aspiration have been described utilizing a needle/biopsy guidance system, which may not be available to many obstetrician/gynecologists. We present a simple technique for transvaginal drainage of large TOAs using a long angiocath needle under transabdominal ultrasound guidance in a patient in whom percutaneous drainage and operative management were not ideal options. This is the first report about the use of this technique. Our patient has recovered fully and remains free of infection 10 months later. Providers should consider this technique when other modalities are not available, are of questionable benefit, or present high potential for additional complications.