ABSTRACT
Rupture of a tuboovarian abscess usually presents with sudden worsening of the patient's condition. Delays in surgical debridement and drainage increase the rate of associated mortality. A 39-year-old woman represents extraperitoneal spillage of abscess contents from rupture of a tuboovarian abscess into the anterior abdominal wall. She presented with gradually worsening abdominal pain over several months. She had fever, pelvic tenderness, an elevated white blood cell count and evidence of a tuboovarian abscess. Also she was found to have an abscess that had ruptured into the anterior left abdominal wall. After triple antibiotic therapy without a clinical improvement, she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and surgical debridement of the abdominal wall. Over the following several weeks, the patient required extensive wound care for wound drainage and skin flap.