BACKGROUND:

Tubo-ovarian abscess as part of pelvic inflammatory disease has different characteristics in postmenopausal patients than in younger women.

CLINICAL CASE:

A 68-year-old woman with a history of five pregnancies, three deliveries and two caesarean sections, with an active sexual life, type 2 diabetes mellitus and chronic arterial hypertension under control. She presented with severe pain in the left iliac fossa with radiation to the right iliac fossa, accompanied by vomiting, which reduced the prescribed intake of non-steroidal anti-inflammatory drugs and antibiotics. Based on the clinical and imaging findings, an exploratory laparotomy was performed, which revealed the following: multiseptal pelvic abscess originating from the right adnexa with drainage of 250 cc of purulent material. There were also findings of: severe adhesive syndrome, mesenteric adenitis, involvement of the cecal appendix with reactive inflammatory processes, and sigmoid colon depulpation with bleeding of 500 cc.

CONCLUSIONS:

Pelvic inflammatory disease associated with a tubo-ovarian abscess in a postmenopausal patient is uncommon, perhaps because of this it is sometimes underdiagnosed, leading to increased morbidity and mortality.