Test yourself
Tubo-ovarian abscess: think complex, thick and tender
3 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1Which appearance suggests a tubo-ovarian abscess?
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Answer a. An abscess shows a thick, hyperaemic wall, septa and debris. A whirlpool sign suggests torsion. A simple cyst has none of these features.
Question 2A febrile patient has pelvic pain, a positive pregnancy test and a complex adnexal mass. What must you consider first?
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Answer c. A positive pregnancy test with an adnexal mass means ectopic pregnancy until proven otherwise, even with fever.
Question 3A normal bedside pelvic scan in a febrile patient with pelvic pain means what?
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Answer b. Early pelvic inflammatory disease often has a normal scan. Treat on clinical grounds and follow local guidance.
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