# The Hidden Danger in Endometriosis: Bilateral Pelvic Abscesses Following Fertility Treatment

## TL;DR

A rare case of bilateral pelvic abscesses after fertility treatment in a woman with endometriosis highlights the importance of advanced imaging for accurate diagnosis.

## Contribution

Demonstrates the diagnostic value of multimodal imaging in identifying infectious complications following ART in endometriosis patients.

## Key findings

- Bilateral tubo-ovarian abscesses were diagnosed using a combination of ultrasound, CT, and MRI.
- Early imaging helped distinguish infection from endometriosis flare-up, preventing sepsis and preserving fertility.

## Abstract

This case report underscores the crucial role of imaging and radiology in the timely diagnosis of a rare but serious complication associated with assisted reproductive technology (ART). A 34-year-old woman with a long-standing history of endometriosis and secondary infertility developed bilateral tubo-ovarian abscesses (TOAs) following in vitro fertilization (IVF). Her presentation included nonspecific gastrointestinal and pelvic symptoms that delayed diagnosis. However, a multimodal imaging approach, combining transvaginal ultrasound, contrast-enhanced computed tomography (CT), and pelvic magnetic resonance imaging (MRI), proved critical in identifying a superimposed infection on chronic adnexal disease. Subsequent surgical exploration confirmed the diagnosis of TOA and hematopyosalpinx. This case illustrates the diagnostic complexity of differentiating infectious processes from endometriotic flare-ups in the post-ART setting and highlights the indispensable role of early and advanced imaging in guiding clinical management, preventing sepsis, and preserving fertility.