Postmenopausal tuboovarian abscess.

Twenty postmenopausal women with tuboovarian abscess were surgically managed at CGMH during 1981 to 1991. Fever with lower abdominal pain were the most common symptoms and signs. Laboratory, sonographic & roentgenologic studies helped in detecting and in making a correct preoperative diagnosis of the origin of the inflammatory complex. Half of the patients had postmenopausal bleeding or discharge. Six tuboovarian abscesses were ruptured at the time of surgery and of these had prolonged hospitalization due to complications. Among the six complications, 2 suffered from intraoperative bowel injury, 2 had postoperative wound infection, 1 colonocutaneous fistula and 1 sigmoid stricture. Abdominal total hysterectomy was tried in all the cases but the surgical procedure was changed to subtotal hysterectomy in two and bilateral salpingo-oophorectomy in one. Septic condition and suspicion of ruptured abscess are indications for immediate operation. No major medical complication developed in the post-operative period. However, the early detection and treatment of unruptured tuboovarian abscess had less surgery related complications and had a shorter mean length of hospitalization.