Ovary - nontumor
Infectious disorders
Abscess

Author: Mohiedean Ghofrani, M.D. (see Authors page)

Revised: 18 September 2017, last major update August 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: "Ovarian abscess" infectious

Cite this page: Ghofrani, M. Abscess. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarynontumorabscess.html. Accessed October 22nd, 2017.
Definition / general
  • Nonspecific abscess localized to the ovary
  • Primary ovarian abscess is defined as inflammation arising in the ovarian tissue
  • Secondary ovarian abscess originates in extraovarian sites
Epidemiology
  • Primary ovarian abscesses are quite rare; most cases of ovarian abscess are secondary
Etiology
  • Primary abscesses may arise due to disruption of ovarian capsule, as in ovulation or surgical intervention (vaginal hysterectomy, ovarian cystectomy, caesarean section, pregnancy, use of intrauterine device, transvaginal or percutaneous needle aspiration of endometrioma or follicle aspiration as part of in vitro fertilization, Tunis Med 2010;88:285), which gives bacteria access to the ovarian stroma
  • Also occurs due to hematogenous and lymphatic spread
  • Secondary ovarian abscess may be associated with tubo-ovarian abscess, salpingitis, ascending infection of lower genital tract (pelvic inflammatory disease) or complication of GI infections (diverticulitis, appendicitis)
Clinical features
  • Nonspecific symptoms, making diagnosis difficult
  • Time between capsule disruption and clinical presentation depends on bacterial inoculum dose, type and virulence and if infection occurred secondary to direct contamination at surgery or via devitalized tissue
Laboratory
  • Most common infectious organisms are Streptococcus type B; other bacteria
Case reports
Treatment
  • Initial treatment is intravenous antibiotics
  • If no response within 72 hours, if abscess ruptures or if surrounding organs are affected, immediate laparoscopy or laparotomy with removal of the ovary is the main treatment
Gross description
  • Large, loculated cyst with pus or secretion
Gross images

Images hosted on PathOut server:

Tubo-ovarian abscess complicating colonic diverticulitis - the left ovary and tube have been transformed into a multicystic mass with a yellow lining (AFIP)

Ovarian abscess associated with Crohn disease shows replacement of the ovarian tissue by yellow, soft tissue (AFIP)

Microscopic (histologic) description
  • Cyst wall often contains ovarian stroma
Microscopic (histologic) images

Images hosted on PathOut server:

Ovarian stroma is replaced by collagenous tissue containing numerous chronic inflammatory cells / xanthogranuloma (AFIP)



Images hosted on other servers:

Tubo-ovarian actinomycosis