Ovaries filled with pus due to infection

The woman had a pus-filled abscess causing acute inflammation, high fever, chills, and abdominal pain.

Two days ago, Ms. Thu Ngan (33 years old, District 3, Ho Chi Minh City) felt pain in her lower abdomen, the pain gradually increased. After enduring it for the second day, she had a fever of 38 degrees Celsius, chills, and severe abdominal pain that made it impossible to walk or stand, so her family took her to Tam Anh General Hospital in Ho Chi Minh City for emergency treatment.

MSc. Dr. Nguyen Thi Thanh Tam, Obstetrics and Gynecology Center, Tam Anh General Hospital, Ho Chi Minh City, said that the patient had a very large abscess on the right adnexa, with pus overflowing into the abdomen, causing severe adhesions to the entire uterus, ovaries, and fallopian tubes. Pseudomembranes covered the surface of the abdominal wall, intestines, uterus, and right adnexa.

The team aspirated 100 ml of pus, removed the intestinal adhesions, peeled off two endometriotic tumors on the right ovary measuring 8 cm, preserved the right ovary, and removed the entire pus-filled and severely damaged right fallopian tube. After that, the doctor cauterized and washed the abdomen, cleaned the pus-filled pseudomembranes, and placed an abdominal drain to monitor the post-operative infection response.

MSc. Dr. Nguyen Thi Thanh Tam performs endoscopy for patient Ngan. Photo: Tue Diem — MSc. Dr. Nguyen Thi Thanh Tam performs endoscopy for patient Ngan. Photo: *Tue Diem*

The laparoscopic surgery was difficult because the patient had a history of two abdominal surgeries, including a midline laparotomy to remove a left ovarian tumor and left fallopian tube due to pus. The previous surgeries had complications of intestinal adhesions to the abdominal wall. The uterus, ovaries, and fallopian tubes also had severe adhesions.

"Removing adhesions, separating, and draining pus from the abdomen made the surgery last nearly 3 hours. The endoscopic team helped the patient recover quickly," said Dr. Tam.

After the surgery, Ms. Ngan was treated with antibiotics and the patient responded well. Because the surgery was completely endoscopic, the patient had less pain, the incision was cosmetic, and she recovered quickly.

According to Dr. Thanh Tam, acute ovarian inflammation needs to be detected promptly and treated early. If delayed, the abscess can rupture, causing peritonitis and sepsis. Women of any age are at risk of the disease. The risk is high in women with genital infections, unsafe sex; bacteria from genital infections enter the uterus, fallopian tubes, and ovaries; conditions of endometritis, hydrosalpinx, chronic pelvic inflammatory disease, or ovarian tumors such as endometriosis, which can become more severely infected, creating abscesses.

Early detection of ovarian abscess can result in ovarian preservation treatment, helping the patient maintain reproductive function and female hormones, avoiding total oophorectomy. On the contrary, if not detected early, the patient will suffer from pelvic infection, blockage and fluid retention in the fallopian tubes, menstrual disorders... leading to infertility.

For prevention, Dr. Thanh Tam encourages women to properly clean their private areas, have safe sex, exercise , get adequate rest, and have regular gynecological examinations every 6-12 months.

Tue Diem

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