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Spontaneous Clitoral Abscess: A Rare Gynaecologic Entity
IMAGE OF THE MONTH
Spontaneous Clitoral Abscess: A Rare Gynaecologic Entity Lauren Jain, MD, Stephanie Lapinsky, MD, Eva Mocarski, MD, FRCSC, Sari Kives, MD, FRCSC Department of Obstetrics & Gynecology, St Michael’s Hospital, University of Toronto, Toronto ON
A
healthy 21-year-old woman presented with a threeday history of vulvar swelling and pain. A tense, spherical clitoral mass was noted on examination. There was no skin breakdown; hair removal had been performed with an electric razor. Management was initiated with sitz baths and oral antibiotics, but symptoms continued to worsen. Two days later, the mass had enlarged and was fluctuant and erythematous. It was tracking to the labia minora, consistent with the behavior of an abscess (Figure 1). The patient was admitted for intravenous antibiotic therapy, examination under anaesthesia, and incision and drainage.
Figure 1.
Careful inspection identified an area of skin breakdown at the inferior aspect of the mass, and an incision was made in this area, taking care to avoid the dorsal artery of the clitoris. This resulted in copious drainage of purulent fluid, and the abscess cavity was packed. There was no obvious pilonidal tract, as suggested by a subset of existing case reports.1 One week later, the patient’s symptoms had improved significantly, and her anatomy was almost completely restored to normal (Figure 2). The patient described has consented to publication of these images. Figure 2.
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IMAGE OF THE MONTH
J Obstet Gynaecol Can 2017;39(1):1e2 Copyright ª 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jogc.2016.11.002
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JANUARY JOGC JANVIER 2017
REFERENCE 1. Koussidis G. Gynecologic rarities: a case of a periclitoral abscess and review of the literature. Am J Obstet Gynecol 2012;207:e3e5.
Spontaneous Clitoral Abscess: A Rare Gynaecologic Entity Lauren Jain, MD, Stephanie Lapinsky, MD, Eva Mocarski, MD, FRCSC, Sari Kives, MD, FRCSC Department of Obstetrics & Gynecology, St Michael’s Hospital, University of Toronto, Toronto ON
A
healthy 21-year-old woman presented with a threeday history of vulvar swelling and pain. A tense, spherical clitoral mass was noted on examination. There was no skin breakdown; hair removal had been performed with an electric razor. Management was initiated with sitz baths and oral antibiotics, but symptoms continued to worsen. Two days later, the mass had enlarged and was fluctuant and erythematous. It was tracking to the labia minora, consistent with the behavior of an abscess (Figure 1). The patient was admitted for intravenous antibiotic therapy, examination under anaesthesia, and incision and drainage.
Figure 1.
Careful inspection identified an area of skin breakdown at the inferior aspect of the mass, and an incision was made in this area, taking care to avoid the dorsal artery of the clitoris. This resulted in copious drainage of purulent fluid, and the abscess cavity was packed. There was no obvious pilonidal tract, as suggested by a subset of existing case reports.1 One week later, the patient’s symptoms had improved significantly, and her anatomy was almost completely restored to normal (Figure 2). The patient described has consented to publication of these images. Figure 2.
JANUARY JOGC JANVIER 2017
l
1
IMAGE OF THE MONTH
J Obstet Gynaecol Can 2017;39(1):1e2 Copyright ª 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jogc.2016.11.002
2
l
JANUARY JOGC JANVIER 2017
REFERENCE 1. Koussidis G. Gynecologic rarities: a case of a periclitoral abscess and review of the literature. Am J Obstet Gynecol 2012;207:e3e5.