Spontaneous Perforated Pyometra with an Intrauterine Device in Menopause: a Case Report

Abstract

Spontaneous perforation of the uterus is rare and only several cases have been reported in the English medical literature. Most of the patients had gynecological malignancy and almost all were associated with cervical occlusion. We report a case of diffuse peritonitis resulting from spontaneously perforated pyometra with an intrauterine device (IUD) inserted for more than two decades. This case differs from others in that the cervical canal was not occluded. In the absence of other possible causes of uterine perforation, the etiology in this case is mostly likely hemorrhagic necrosis related to the long-term IUD.

Pneumoperitoneum Due to Spontaneous Uterine Perforation Caused by Pyometra – A Rare Finding and a Diagnostic Challenge

“…Pyometra, although rare in the general population, is found more frequently in postmenopausal women as a result of occlusion of the cervical canal by malignant or benign tumors, surgery, radiotherapy, and senile cervicitis. [7,8] The classical triad includes suprapubic pain, postmenopausal vaginal bleeding, and vaginal pus discharge, and. [7,9] However, more than 50% of all cases are asymptomatic.…”