Infected ectopic pregnancy presenting as unilateral tubo-ovarian abscess

Ectopic pregnancy may be a dramatic occurrence, such as in the acutely ruptured extrauterine entity, or diagnosis may be delayed in the chronic ectopic gestation. Eight cases of infected ectopic pregnancy simulating tubo-ovarian abscess are reported; the diagnosis may be difficult and misleading. Symptoms and signs include abdominal pain and vaginal bleeding following a period of amenorrhea, usually accompanied by fever. All patients in our series presented with a picture of tubo-ovarian or pelvic abscess; however, the diagnosis of infected ectopic pregnancy was made preoperatively in all due to a positive β-hCG test. Surgery in our cases included unilateral salpingo-oophorectomy in 7, and salpingectomy in one. Attention was drawn to the fact that, in the case of unilateral tubo-ovarian abscess, infected ectopic pregnancy should be suspected whenever preoperative β-hCG is positive.