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Right tuboovarian absces after laparotomy for left tubovarian abscessFrom: Carlos Rubio (crubiol@meditex.es)Mon Mar 20 15:12:06 2000
23 y.o, G1 Para 1, pt complaining of lower left sided inguinal pain and metrorragia. Negative pregnancy test ,painful bimanual palpation,peritonism signs, no fever, high white cells count and high VSG, US showed a left 7 cm adnexal mass compatible with tuboovarian abscess, retroverted uterus and secretor endometrium. Laparotomy showed a left large tuboovarian abscess with involvement of sigmoid. Pus was taken for cultures. Debridation and left anexectomy was made. Uterus retroversion corrected after debridation from the sigmoid. Right tube and ovary was normal on inspection. Good postop evolution, afebrile, on IV gentamicin and clindamicin for 4 days and oral clindamicin for 10 days. Hospital discharge on the seventh day postop. The cultures came back as NO GROWTH. Sutures removed 10 days postop, good evolution, no clinical signs. 20 days postop new admission for lower right abdominal pain and new 3.5 cm tuboovarian abscess found on the right adnexa. Started a new course of oral doxiciclin and IM ceftriazona. Please suggest further management.
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