Perforation of a pyometra mimicking a perforated peptic ulcer

Rasmussen, Kirsten; Luckow, A.

doi:10.1007/bf02390360

Cited by 8 publications

(4 citation statements)

References 4 publications

(6 reference statements)

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“…Malignant tumors were present in 8 (22.8%) of these cases, whereas the other benign states included atrophic cervicitis in 19, benign polyps in 3, radiation cervicitis in 2, vaginal stone in 1, and unknown in 2 cases as the cause of perforation. [5][6][7][8][9] Whatever the pathological findings, cervical occlusion was noted in 33 cases (94%). It appears that cervical occlusion is so severe that the intrauterine pressure increases due to the collection of pus, secondary to a distended myometrium which finally ruptures.…”

Section: Discussionmentioning

confidence: 93%

Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case

et al. 2000

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We report a rare case of generalized peritonitis due to a ruptured pyometra in an 86-year-old woman, and also conduct a review of the previous Japanese literature. The patient presented with muscle guarding and rebound tenderness. Computed tomography (CT) disclosed a cystic mass in the peritoneal cavity, in which an air-fluid level was noted. Pneumoperitoneum around the uterus due to gas production of anaerobic bacteria was noted on a CT. At laparotomy, the uterus was markedly enlarged with a necrotic area on the uterine fundus, which was found to be perforated. A supravaginal hysterectomy and drainage were performed. We found only eight cases of a ruptured pyometra presenting as pneumoperitoneum in the Japanese literature between 1977 and 1999. The most common cause of pneumoperitoneum is a perforation of the gastrointestinal tract. However, other possible causes, as seen in our patient, should also be taken into consideration. Although it is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

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Section: Discussionmentioning

confidence: 93%

Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case

et al. 2000

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“…We collected data from 47 patients diagnosed with spontaneous rupture of pyometra between 1949 and 2011 [2,3,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40]. The available literature was carefully reviewed, and our patients' descriptions were included to evaluate the characteristics related to outcomes in cases of spontaneous rupture of pyometra.…”

Section: Methodsmentioning

confidence: 99%

Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Ikeda

Takahashi

Kurachi

2013

Gynecol Obstet Invest

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Background/Aims: The spontaneous perforation of pyometra is very rare and is associated with a poor prognosis. The present study aimed to evaluate the clinical characteristics and prognostic factors for patient survival. Patients and Methods: We reported on 7 patients with spontaneous rupture of pyometra. We also reviewed 47 additional published cases. Thus, all 54 patients were analyzed for mortality. Results: We investigated the prognosis in 44 of 54 patients, excluding 8 patients with undocumented outcome and 2 who died of other diseases. The mortality rate was 25% (11 of 44). In univariate analysis, variables such as age, correct preoperative diagnosis, comorbidities, the presence of malignancy, and hysterectomy were not significant between surviving and deceased patients. In bacterial cultures from the peritoneal cavity, the most common etiological organisms were Escherichia coli and anaerobes such as Bacteroides and Peptococcus species. The rate of isolation of anaerobic bacteria was significantly increased in patients who died (odds ratio, 6.33; 95% confidence interval, 1.28-31.02; p = 0.04). Conclusion: Antibiotic therapy for E. coli and anaerobes should be considered in patients with spontaneous perforation of pyometra.

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“…In case 2, suturation of the perforation in two layers was carried out because of the poor general condi- tion of the patient [4], Peritoneal lavage was conducted in all cases. One patient died of pneumonia on the 14th day after operation [8]. Culture of the peritoneal fluid pro duced E. coli in 5 of 7 cases (71 %).…”

Section: Onclusionsmentioning

confidence: 99%

“…Fifteen cases of perforated pyometra including 9 cases of causative disease such as leiomyoma and carcinoma of the uterus cervix were reviewed in 1993 [11], The remaining 6 cases of idiopathically spontaneous perforation [3][4][5][6][7][8] an additional two reports [9,10], and the present case are summarized in Perforated Pyometra with Pneumoperitoneum Histological examination of the removed specimen re vealed a 10-mm perforation on the anterior wall of the uterine body coated with pus (arrow). table 1.…”

Section: Onclusionsmentioning

confidence: 99%

Spontaneous Perforated Pyometra Presenting as Pneumoperitoneum

Ikematsu¹,

Kitajima²,

Kamohara³

et al. 1996

Gynecol Obstet Invest

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Background: Spontaneous perforated pyometra presenting as pneumoperitoneum is extremely rare. Case report: An 80-year-old Japanese female with spontaneous perforating pyometra presenting as pneumoperitoneum is reported. The patient came to our institute with severe abdominal pain. Routine abdominal examination showed muscular defense, and plain chest roentgeno-grams revealed infradiaphragmatic free gas. Subsequent computed tomography also demonstrated pneumoperitoneum. Laparotomy was performed on the basis of a tentative diagnosis of perforation of the gastrointestinal tract but revealed a perforated pyometra. A simple hysterectomy was performed. The histological diagnosis of the surgical specimen was acute endometritis without neoplasm. The present report is the third case of spontaneous perforated pyometra with pneumoperitoneum to date. Conclusion: Although uterine disease presenting as pneumoperitoneum is rare in elderly patients with an acute abdomen, the possibility of a perforated pyometra should be considered in the differential diagnosis.

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Perforation of a pyometra mimicking a perforated peptic ulcer

Abstract: We report on a patient with a pyometra which leaked into the peritoneal cavity and was mistaken for a perforated peptic ulcer. There was no associated stenosis of the cervical canal.

Cited by 8 publications

References 4 publications

Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case

Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case

Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Spontaneous Perforated Pyometra Presenting as Pneumoperitoneum

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