Hindawi Publishing Corporation Case Reports in Medicine Volume 2012, Article ID 413185, 3 pages doi:10.1155/2012/413185 Case Report Tuboovarian Abscess due to Colonic Diverticulitis in a Virgin Patient with Morbid Obesity: A Case Report Zafer Selc¸ uk Tuncer,1 Gokhan Boyraz,2 Senem O¨zge Y u¨cel,2 I˙lker Selc¸ uk,2 and Aslıhan Yaziciog˘lu2 1 Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey 2 Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey Correspondence should be addressed to Gokhan Boyraz, gokhan.boyraz@gmail.com Received 17 June 2012; Accepted 22 July 2012 Academic Editor: Faustino R. Pe´rez-Lo´ pez Copyright © 2012 Zafer Selc¸uk Tuncer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Since tuboovarian abscess is almost always a complication of pelvic inﬂammatory disease, it is rarely observed in virgins. A 30- year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. Her abdominopelvic computed tomography scan revealed bilateral multiseptated cystic masses with prominent air-ﬂuid levels suggesting tuboovarian abscesses. The sigmoid colon was lying between two tuboovarian masses, and its borders could not be distinguished from the ovaries. The patient was presumed to have bilateral tuboovarian abscesses which developed as a complication of the sigmoid diverticulitis. She was administered intravenous antibiotic therapy followed by percutaneous drainage under ultrasonographic guidance. She was discharged on the twenty second day with prominent clinical and radiological improvement. Diverticulitis may be a reason for development of tuboovarian abscess in a virgin patient. Early recognition of the condition with percutaneous drainage in addition to antibiotic therapy helps to have an uncomplicated recovery. 1. Introduction A tuboovarian abscess reﬂects an agglutination of pelvic organs including the tube, ovary, and bowel forming a palpable complex. It represents an end-stage process of acute pelvic inﬂammatory disease. Tuboovarian abscess has been reported to complicate 18–34% of patients with pelvic inﬂammatory disease [1, 2]. Risk factors for tuboovarian abscess are similar to that of pelvic inﬂammatory disease and include multiple sexual partners, intrauterine device, and low socioeconomic status [3]. Since the disease com- monly is caused by the sexually transmitted microorganisms, intercourse with a partner having infection is the most important risk factor in tuboovarian abscess formation. However, gynecologic surgery, genital malignancy, in vitro fertilization treatment, and perforated appendicitis have also been shown to cause tuboovarian abscess in the literature [4–7]. Diverticulosis is a common condition in elderly popu- lation. It is deﬁned as a pocket of mucosa which herniates through areas of weakness usually at vascular entry sites [8]. One of the complications of diverticulosis is diverticulitis which will develop in approximately 10% of the patients [9]. Occasionally acute diverticulitis will involve the female reproductive organs which lie in close proximity to the sigmoid colon resulting in tuboovarian abscess. A case of tuboovarian abscess associated with diverti- culitis and treated with percutaneous drainage in addition to antibiotic therapy in a young virgin patient with morbid obesity was reported. 2. Case Presentation A 30-year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. She was also suﬀering from malodorous vaginal discharge and