Pyometra: a potentially lethal differential diagnosis in older women

Lien, Wan‐Ching; Ong, Ai-Wey; Sun, Jen‐Tang; Tsai, Ming-Tse; Lai, Tsung‐Ching; Liu, Yueh-Ping; Chen, Shyr‐Chyr; Wang, Hsiu-Po

doi:10.1016/j.ajem.2009.08.024

Cited by 17 publications

(14 citation statements)

References 9 publications

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“…In many cases, emergency abdominal total hysterectomy is performed because of the risk of malignancy [2,5]. Many studies of pyometra have been reported by surgeons, and it has been suggested that the low level of accuracy of diagnosis of pyometra preoperatively comes from a lack of knowledge of the disease on the part of surgeons [8].…”

Section: Discussionmentioning

confidence: 99%

A case of pyometra treated with endoscopic ultrasound-guided drainage

et al. 2012

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A 90-year-old woman was admitted to our hospital because of a high-grade fever and appetite loss. On computed tomography scan, a huge cystic lesion about 10 cm in diameter was observed in the pelvic cavity, attached to the vagina and the neck of uterus. Pyometra was strongly suspected; however, a probe could not be inserted into the opening of the uterus because of atrophic changes. Therefore, we decided to perform endoscopic ultrasound (EUS)-guided drainage of the pyometra using the transrectal route. Foul-smelling yellow-brown pus was aspirated. A guide-wire was inserted and a 7 Fr catheter was inserted into the pyometra through an external fistula. We thus completed the treatment of pyometra without surgical resection.

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Section: Discussionmentioning

confidence: 99%

A case of pyometra treated with endoscopic ultrasound-guided drainage

et al. 2012

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“…L'incidence rapportée dans la littérature est de moins de 1 % [3]. Dans un travail récent, Lien et al, rapportent une série de sept cas sur une durée de cinq ans [4]. Cette pathologie touche essentiellement les femmes ménopausées âgées (âge moyen 73 ± 9 ans) [4].…”

Section: Discussionunclassified

“…Dans un travail récent, Lien et al, rapportent une série de sept cas sur une durée de cinq ans [4]. Cette pathologie touche essentiellement les femmes ménopausées âgées (âge moyen 73 ± 9 ans) [4]. Cependant ces patientes n'ont pour leur majorité pas présenté de tableau de choc septique (un sur sept).…”

Section: Discussionunclassified

Une endométrite peu banale

Wallet

Lunel

Cassar

et al. 2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…Hysterectomy with bilateral salpingo-oophorectomy may be the best choice for perforated pyometra, because peritoneal lavage with drainage is not effective in the control of infection [11]. However, because such patients are elderly, under poor general conditions, and often with unfavorable prognoses, intensive pre-and postoperative care of respiratory and circulation is essential [12]. Cases of spontaneously perforated pyometra associated with non-malignancy have better prognoses than those with malignancy.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous uterine perforation of pyometra presented as an acute abdomen: A case report

Jeon

Shin

Kim

et al. 2012

Korean J Obstet Gynecol

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Pyometra is an uncommon condition in general population and caused by impairment of natural drainage of the cervix as a result of benign or malignant diseases. Spontaneous uterine perforation, a very rare complication of pyometra, carries signifi cant morbidity and mortality and should be considered in the differential diagnosis of other peritonitis. Preoperative diagnosis of perforated pyometra is diffi cult due to old age, poor general condition, and symptoms that present as abdominal pain related to gastrointestinal diseases. If a diagnosis of perforated pyometra is delayed, then it will be associated with increased morbidity and mortality. In the causes of uterine perforation, pyometra should be considered because of requiring proper intervention. A diagnosis of spontaneous perforated pyometra should always be kept as a possibility in all cases of abdominal pains associated with peritonitis in elderly women.

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Pyometra: a potentially lethal differential diagnosis in older women

Cited by 17 publications

References 9 publications

A case of pyometra treated with endoscopic ultrasound-guided drainage

A case of pyometra treated with endoscopic ultrasound-guided drainage

Une endométrite peu banale

Spontaneous uterine perforation of pyometra presented as an acute abdomen: A case report

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