The general use of antibiotics has resulted in a decrease in the incidence and severity of pelvic inflammatory disease. Nevertheless, patients with tubo-ovarial abscess are still being seen at Bellevue Hospital. Some of these abscesses rupture and result in severe generalized peritonitis that requires laparotomy. If the rupture is not diagnosed, the patient will die. The possibility of rupture into the free peritoneal cavity must constantly be borne in mind, as the prognosis depends primarily on the speed with which the diagnosis is made and the time interval between rupture and laparotomy.
Of the 24 papers dealing with ruptured pelvic inflammatory masses that were published during the 16 years covered by this report, only 2 were concerned with ruptured tubo-ovarial abscesses. These reported a total of 51 cases. I do not feel, however, that this is a true estimate of the incidence of this condition. The fact that, except for
Lardaro HH. SPONTANEOUS RUPTURE OF TUBO-OVARIAL ABSCESS INTO THE FREE PERITONEAL CAVITY. JAMA. 1954;156(7):699-701. doi:10.1001/jama.1954.02950070027007