Laparoscopic Management of Tubo-Ovarian Abscess

Until the mid 1980's, except for adhesiolysis, laparoscopy was primarily a diagnostic tool in the management of pelvic inflammatory disease (PID). Recently, however, laparoscopy as a therapeutic modality has been advocated for PID with tubo-ovarian abscess (TOA). The largest study in the United States was reported by Reich in 1987, in which 96% of patients had complete resolution of abscess and symptoms postoperatively. Two cases are presented, one with unilateral TOA, the other with pyosalpinx. Operative laparoscopy was performed with blunt dissection, adhesiolysis, aspiration of purulent fluid and removal of abscess wall. Both patients developed transient ileus which responded well to conservative measures.