All issues > Volume 43(3); 2000

Case Report

J Korean Pediatr Soc. 2000;43(3):432-437. Published online March 15, 2000.

A Case of Bilateral Tubo-Ovarian Abscesses in a One-and-Half Year-Old Girl

Mun Hee MH Kim¹, Young Kyoo YK Shin¹, Baik Lin BL Eun¹, Sun Han SH Kim², Hai Joong HJ Kim³, Sang Hoon SH Cha⁴, Young-Sik YS Kim⁵

¹Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
²Department of General Surgery, College of Medicine, Korea University, Seoul, Korea
³Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea
⁴Department of Diagnostic Radiology, College of Medicine, Korea University, Seoul, Korea
⁵Department of Anatomical Pathology, College of Medicine, Korea University, Seoul, Korea

Abstract

Tubo-ovarian abscess is an end-stage disease of acute pelvic inflammatory disease(PID). Since most cases of PID are caused by sexually transmitted microorganisms, this is very rare in children. Here, we report an 1¨o-year-old girl with bilateral tubo-ovarian abscesses. She was admitted to our department with chief complaints of fever, vomiting and diarrhea. Abdominal ultrasonography and CT scanning of the patient showed solid and cystic masses in pelvic cavity. It was very difficult to differentiate the lesions from abscess and tumor. In addition, intravenous pyelography(IVP) and abdominal CT scanning of the patient showed both hydronephrosis and ureteral dilatation. Because of severe visceral adhesions, we could not perform laparoscopic examination of the pelvic masses. By exploratory operation and frozen biopsy, the masses were confirmed as tubo-ovarian abscesses and they were drained. In the bacterial culture, K. pneumoniae and E. coli were grown. The patient was treated with sensitive antibiotics and recovered from her disease. After 4 weeks of operation, IVP showed no abnormal findings and voiding cystourethrography(VCUG) showed grade I vesicoureteral reflux of the left side. It was suggested the hydronephroses were developed by the ureteral obstruction of tubo-ovarian abscesses.

Keywords :Tubo-ovarian abscess, Children