Abstract

SANCHEZ SILVA TORRIANI, Ronald Roberto; PALOMINO BALDEON, Juan Carlos  and  DIAZ HERRERA, Jorge. Complejo tubo-ovárico: revisión de casos en el Hospital Nacional Cayetano Heredia (1990-1999). Rev Med Hered [online]. 2003, vol.14, n.3, pp.134-139. ISSN 1018-130X.

Objective: To determine the epidemiological, clinical and management characteristics of tubo-ovarian complex.Material and methods: A retrospective study of 65 patients hospitalized with diagnosis of tubo-ovarian complex was conducted in gynecology division, at the Hospital Nacional Cayetano Heredia of Lima, Perú, between January 1990 and December 1999. We registered demographic data, prior history of diseases, clinical manifestations, laboratory findings, medical and surgical treatment, surgical findings and complications, hospitalization period and follow up data. Results: Tubo-ovarian complex was 0.72% of the gynecologic admissions of this hospital. It was more frequent in the third and fourth decades of life (median = 31.9 years), marriage status (44.6%) and multiparous (53.8%). There was no statistical relationship between intrauterine device use and surgically proven tubo-ovarian abscess localization. The most frequent presenting complaints were pelvic pain (96.9%), fever (76.9%), cervical motion tenderness (60%), and adnexial mass presence (58.5%). Pelvic ultrasonography showed the highest positivity in diagnosis of tubo-ovarian complex (91.3%), after laparoscopy (100%), despite it was done only in 4 patients. Abscess drainage plus peritoneal lavage underwent similar complications than other techniques, but 2 patients required further surgical interventions. In the follow up of 24 patients, 40% undergo pelvic pain. There were no deaths in this study. Conclusions:s: Tubo-ovarian complex affects fertility and ovarian function. Pelvic ultrasonography showed high positivity in diagnosis. Laparotomy plus abscess drainage and peritoneal lavage is a conservative technique with similar frequency of intra and postsurgical complications. ( Rev Med Hered 2003; 14: 134-139).

Keywords : Tubo-ovarian complex; tubo-ovarian abscess; pelvic inflammatory disease.

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