Suture-Induced Tubo-Ovarian Abscess: A Case Report with Literature Review
Introduction Suture is an underreported cause for tubo-ovarian abscess (TOA) that can cause significant morbidity. This report describes a case of TOA arising from a silk suture three years after bilateral tubal ligation. Case presentation A 38-year-old woman with a history of tubal ligation presented with persistent…
2025 1,557 reads 1 citation
Case Reports
Suture-Induced Tubo-Ovarian Abscess: A Case Report with Literature Review
IntroductionSuture is an underreported cause for tubo-ovarian abscess (TOA) that can cause significant morbidity. This report describes a case of TOA arising from a silk suture three years after bilateral tubal ligation.
Case presentationA 38-year-old woman with a history of tubal ligation presented with persistent pelvic pain and fever. Imaging revealed a suspicious left adnexal mass with features concerning for malignancy or abscess. Surgical exploration revealed a TOA adherent to surrounding structures, containing a retained silk suture from prior surgery. The abscess and suture were removed, and histopathology confirmed chronic inflammation without malignancy. The patient underwent additional procedures for thorough management, including polypectomy and contralateral tubal ligation.
Literature ReviewA total of nine cases of TOAs and suture-induced abscesses were reviewed. Of these, seven were TOAs, six of which occurred postoperatively. Three cases developed following tubal ligation procedures. The abscesses ranged in size from 1 to 7.6 cm. The interval between the presumed inciting event and abscess detection varied widely, with one case presenting more than three decades after surgery. Isolated microorganisms included Escherichia coli, Streptococcus pyogenes, and Peptostreptococcus anaerobius. All patients underwent surgical intervention via various approaches, and several also received adjunctive antibiotic therapy.
ConclusionSuture-induced TOA following sterilization may result in considerable morbidity, and surgical intervention may provide favorable outcomes.
Keywords Tubo-ovarian abscess Pelvic inflammatory disease Silk suture Foreign body reaction Serilization All subjects
Barw Medical Journal. 2025;3(3):56–61