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Pelvis » Female Pelvis (Gynecology)
Left ovarian abscess and retained IUCD in situ
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Presentation A 51 year old woman presented with fever, nausea and elevated white cell counts. An abdomino-pelvic ultrasound was performed. The patient had undergone removal of a previously placed IUCD.
Caption: Sagittal scan of the uterus
Description: The endometrial cavity shows a linear, high amplitude echo. This possibly represents a retained piece of the IUCD.
Caption: Transverse image of the uterus
Description: The linear echo within the endometrial cavity is noted again in this image.
Caption: Transverse image of the left adnexa
Description: A complex left adnexal cystic mass is noted. The mass is septated and the left ovary could not be identified separately from it.
Caption: Transverse scan demonstrating the left mass
Description: The left sided cystic adnexal mass exhibits thick septations. The fluid within the mass shows inhomogeneous echoes within.
Caption: Magnified view of the left mass
Description: The septated cystic left adnexal mass is seen again. The thick septations appear quite irregular, raising a suspicion for neoplasm.
Caption: Transvaginal view of the left adnexal mass
Description: The transvaginal scan better demonstrates the internal characteristics of the complex mass in the left adnexa. The thick septae and the inhomogeneous echoes in the different fluid compartments of the mass are better appreciated in this view.
Differential Diagnosis Left ovarian abscess, left ovarian malignancy and retained IUCD
Final Diagnosis Left ovarian abscess with a retained piece of IUCD
Follow Up This patient underwent a hysterectomy and bilateral salpingo-oopherectomy. Histopathology demonstrated a left ovarian abscess. The uterus had the intra-uterine device in situ and showed evidence of chronic endometritis. Both the tubes showed changes of chronic salpinigits.
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