Wei Eric T, Mahmoud Amir-Ali, Naser-Tavakolian Kiyon, Yun Sung Dr Lok
Stony Brook University Hospital, Department of Radiology, 101 Nicolls Rd level 4, Stony Brook, NY 11794, USA.
Stony Brook Renaissance School of Medicine, 100 Nicolls Rd, Stony Brook, NY 11794, USA.
Radiol Case Rep. 2022 May 11;17(7):2501-2505. doi: 10.1016/j.radcr.2022.04.027. eCollection 2022 Jul.
Infected endometriomas are rarely described in the literature with most cases being managed laparoscopically or open laparotomy. We present an infected endometrioma in a 48-year-old female with a history of extensive peritoneal adhesions in the setting of a contralateral tubo-ovarian abscess that was unresponsive to antibiotic therapy. Initially, the tubo-ovarian abscess was percutaneously drained, however, the patient did not clinically improve. The suspected infected endometrioma was then percutaneously drained which then led to clinical improvement. Typically, endometriomas are managed laparoscopically chiefly due to the risk of content spillage into the peritoneum, however, the case presented demonstrated that an ultrasound-guided transabdominal approach drainage can be feasible in a surgically complicated patient who was unresponsive to antibiotics in which a percutaneous approach was favored rather than a surgical approach.
感染性卵巢巧克力囊肿在文献中鲜有描述,大多数病例通过腹腔镜或开腹手术治疗。我们报告一例48岁女性的感染性卵巢巧克力囊肿,该患者有广泛腹膜粘连病史,同时合并对抗生素治疗无反应的对侧输卵管卵巢脓肿。最初,经皮穿刺引流了输卵管卵巢脓肿,但患者临床症状未改善。随后经皮穿刺引流了疑似感染性卵巢巧克力囊肿,患者临床症状得以改善。通常,由于囊肿内容物有溢入腹腔的风险,卵巢巧克力囊肿主要通过腹腔镜治疗,然而,本病例表明,对于手术复杂且对抗生素治疗无反应的患者,超声引导经腹穿刺引流是可行的,在此类患者中,经皮穿刺引流比手术治疗更可取。