• M Varras, D Polyzos, E Perouli, P Noti, I Pantazis, and Ch Akrivis.
• Department of Gynaecology, G. Gennimatas General Hospital, Second District National Health System, Athens, Greece.
• Clin Exp Obstet Gyn. 2003 Jan 1;30(2-3):117-21.

ObjectivePelvic inflammatory disease (PID) is a serious condition that can lead to abscess formation. The purpose of this study was to identify the different sonographic markers on gray scale and color Doppler sonography in tubo-ovarian abscesses.Material And MethodsThe study group consisted of 25 women in whom the presence of tubo-ovarian abscess was confirmed by surgery and histopathology and their ultrasound records were analyzed retrospectively.ResultsPresence of a mass was found in all cases. The maximum diameter of the mass was 5 cm in two cases and between 5 cm and 10 cm in 23 cases. The mass was demonstrated at the anatomic position of the ovary in 21 cases (84%) and at the cul-de-sac in four cases (16%). The mass was a simple cyst in two cases (8%), in four cases it was cystic with diaphragms (16%), in four cases it was a thickened tube-shaped structure with multiple internal echoes (16%) and in 15 cases it was a mixture of cystic and solid elements (60%). Pyosalpinges with fluid-fluid levels were found in two cases. Fluid in the cul-de-sac was observed at a rate of 48%. Color Doppler sonography demonstrated abundant blood flow in the borders and the septa of the tuboovarian abscesses in 90% of the studied cases.ConclusionThe ultrasonographic findings of tubo-ovarian abscesses are not specific. The presence of a mass at the anatomic position of the ovary or at the cul-de-sac in combination with an increased number of white blood cells, elevated erythrocyte sedimentation rate and clinical findings are helpful for a correct diagnosis. Also, the color Doppler flow can further characterize the nature of the pelvic mass by detecting a significant rich blood flow in most cases of tuboovarian abscesses.

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