A tubo-ovarian abscess (TOA) is a serious complication of pelvic inflammatory disease in which infection leads to the formation of an abscess (walled-off collection of pus) involving the fallopian tube and ovary, often fusing them into a single inflammatory mass. On ultrasound, a TOA typically appears as a complex, thick-walled, multiloculated mass in the adnexal region, containing both solid and cystic components with internal echoes representing pus and debris. The borders between the tube and ovary may be indistinguishable. Surrounding free fluid, increased vascularity on Doppler, and loss of the normal ovarian architecture support the diagnosis. TOA requires aggressive antibiotic treatment and may necessitate image-guided drainage or surgical intervention if medical therapy fails.
Sonography Term