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  • Title: Unilateral tubo-ovarian abscess and intrauterine contraceptive devices.
    Author: Dawood MY, Birnbaum SJ.
    Journal: Obstet Gynecol; 1975 Oct; 46(4):429-32. PubMed ID: 1165878.
    Abstract:
    The association of unilateral tubo-ovarian abscess and the presence or use of an intrauterine contraceptive device (IUD) appears to be a definite clinical entity. Four cases of unilateral tubo-ovarian abscess in patients using the IUD are presented. Three patients had a Dalkon Shield IUD and one had a Lippes Loop. Two patients had unilateral salpingo-oophorectomy while the other 2 had total abdominal hysterectomy and bilateral salpingo-oophorectomy. The differential diagnosis, possible etiology, route and mode of infection, and management are discussed. 4 cases of unilateral tuboovarian abscess in patients using an IUD are presented; 3 of the 4 patients had a Dalkon shield and 1 had a Lippes loop. These cases present the problem of diagnosis and treatment as the presence of pelvic mass in an IUD user may be due to an ectopic pregnancy, ovarian cyst, or a pelvic or tuboovarian abscess. Unruptured tuboovarian abscess requires conservative treatment with antibiotics initially and surgery if there is an unsatisfactory response. These patients display a high fever and purulent cervical discharge. An ascending infection is associated with IUD use and recent investigations implicate the tail, especially the compound variety. Trauma to the endometrium by the IUD may initiate the infection and the finlike projections of the IUD may cause further trauma. The connection of unilateral tubooovarian inflammatory mass with the IUD user should alert more clinicians to this possibility.
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