Giang arrived at Tam Anh General Hospital, Ho Chi Minh City (TP HCM), with a fever of 40 degrees Celsius, a rapid pulse of 126 beats per minute, and severe lower abdominal pain. Dr. Ngo Thi Binh Lua, from the Obstetrics and Gynecology Center, noted a white blood cell count of 38 G/L (normal range below 10 G/L), indicating a significant infection.

The patient had a large abscess adjacent to the uterus, with inflammation spreading to surrounding tissues. This displaced the uterus to the right and compressed the left ureter, causing ureteral dilation and mild hydronephrosis in the left kidney. The lesion was adhered to the rectum and sigmoid colon, leading to an inflammatory reaction in the bowel wall.

Following a consultation, doctors diagnosed the patient with a large left adnexal abscess, severe infection, and pelvic adhesions. She also had uterine fibroids, an intrauterine device (IUD) in her uterus, and moderate anemia.

Dr. Lua explained that an adnexal abscess is the formation of a pus collection in the ovary, fallopian tube, or adjacent structures, often a severe complication of pelvic inflammatory disease. The condition can progress silently for a long time, only being discovered when the abscess is large or complications arise.

Giang received antibiotic treatment, intravenous fluids, pain relief, and pre-surgical resuscitation. The team cross-matched blood before surgery to ensure safety in case of blood loss during the operation.

Surgeons performed adhesiolysis, removed the left adnexa containing the abscess (left ovary and left fallopian tube), and placed a drain to control the infection. The IUD, which had lost its string, was also removed.

The surgical team operates on Giang. Photo: Tam Anh General Hospital

Dr. Lua stated that if a patient delays seeking hospital care until the lesion has spread extensively or the infection is uncontrolled, they might require major surgery, including the removal of the uterus and additional ovaries.

Post-surgery, Giang received broad-spectrum antibiotics and close monitoring. As she suffered from malnutrition and severe anemia, she was given three units of blood, treated for low sodium and potassium levels, and provided with nutritional supplements.

A midwife checks Giang's blood pressure. Photo: Tam Anh General Hospital

According to Dr. Lua, adnexal abscesses typically occur when bacteria from the vagina or cervix ascend to the uterus, fallopian tubes, and ovaries, causing prolonged inflammation and pus formation. The condition is common in women of reproductive age, those with a history of pelvic inflammatory disease, unsafe sexual practices, postpartum infections, or compromised immune systems.

Dr. Lua advises women using contraception to have regular follow-up and gynecological examinations every 6-12 months. Patients should seek immediate medical attention if they experience symptoms such as persistent lower abdominal pain, fever, abnormal vaginal discharge, painful urination, or pain during intercourse.

Minh Tam

* The patient's name has been changed