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Bartholin Abscess, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • The Bartholin glands are located inferiorly on either side of vaginal opening:

    • Ducts open on sides of labial vestibule.

  • Obstruction of duct produces a usually painless cyst:

    • Infection o...

Diagnosis

Signs and Symptoms

  • Swollen, painful labia

  • Tender, fluctuant mass on posterolateral margin of vestibule of vagina

  • Warmth, erythema

History

Acute onset: 
  • Painful, unilateral labial swelling

  • Pain with...

Treatment

Ed Treatment/Procedures

  • Prompt incision and drainage using local anesthesia with patient in lithotomy position

  • Narcotic analgesia for patient comfort

  • Alternative approaches include:

    • Simple incis...

Follow-Up

Disposition

Admission Criteria

  • Sepsis

  • Significant cellulitis

  • Evidence of necrotizing infection

Discharge Criteria

Well-appearing patients may be discharged with designated follow-up plan. 

Issues for Referral

Pearls and Pitfalls

  • Do not mistake a nontender Bartholin cyst, which does not require immediate treatment, for an inflamed abscess.

  • Consider malignancy as an alternative cause of a mass, particularly i...

Additional Reading

  • Bhide  A, Nama  V, Patel  S, et al. Microbiology of cysts/abscesses of Bartholin's gland: Review of empirical antibiotic therapy against microbial culture. J Obstet Gynaecol.  ...

Codes

ICD9

  • 098.0 Gonococcal infection (acute) of lower genitourinary tract

  • 616.3 Abscess of Bartholin's gland

ICD10

  • A54.02 Gonococcal vulvovaginitis, unspecified

  • N75.1 Abscess of Bartholin's gland

SNOMED

  • 676...

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