Asian Journal of Case Reports in Surgery

Introduction: The pelvic abscess is a circumscribed collection of infected exudates.  In young women, a pelvic abscess occurs as one of the complications of pelvic inflammatory disease. The incidence of pelvic abscess is less than 1 % in a patient undergoing obstetric and gynaecological surgeries. Here we report a case of large pelvic abscess in a young female patient who presented with severe backache, urinary retention and abdominal pain and remained afebrile throughout the course of her illness.

Case Presentation: Our patient young female 30 years in age, presented with complaints of inability to pass urine for 4 hours with severe backache and abdominal pain. She had undergone tubectomy operation 4 years back. She had no history of vaginal discharge, fever, loss of appetite, weight loss or severe abdominal pain. Ultrasonography revealed large pelvic abscess measuring 13.18 x 13.84 x 13.91cm, volume-1328cc with homogenous internal echoes and thick wall. Laparotomy was done, dense intestinal and omental adhesions with the abscess wall removed. About 1.5 litres of pus drained from the abscess cavity. Pelvic ultrasound is the method of choice to evaluate a pelvic mass as it differentiates between fluid filled lesion and solid lesion, is inexpensive. Laparotomy with drainage of the abscess and lavage of the cavity is the mainstay of the treatment.

Conclusion: Our patient had non-specific symptoms. She remained afebrile throughout the course of illness and recovery. Surgical drainage and adhesiolysis through laparotomy gave her complete recovery.