Spontaneous rupture of pyometra

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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“…5,10,11 The age at diagnosis ranged from 41 to 86 years, with a mean of 68.4 years. Three patients had a history of diabetus mellitus.…”

Section: Discussionmentioning

confidence: 99%

“…We report herein a case of generalized peritonitis due to a spontaneous rupture of a pyometra presenting as pneumoperitoneum in an 86-year-old woman, which was Reprint requests to: A. Nakao (Received for publication on Mar. 15, 1999; accepted on Nov. 11,1999) found to be perforated. The right ovary included a 4-cm serous cyst.…”

Section: Introductionmentioning

confidence: 96%

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

et al. 2000

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“…Spontaneous perforation with diffuse peritonitis is very rare, and the incidence is 0.01-0.05% for all cases of pyometra. 2 This article reports a case of spontaneous pyometra perforation with subsequent peritonitis in a 60-year-old female.…”

Section: Introductionmentioning

confidence: 97%

Spontaneous Perforation of Pyometra: Total Abdominal Hysterectomy

Chauhan

Malhotra

et al. 2012

Journal of Gynecologic Surgery

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Background: This case report describes an uncommon complication of generalized peritonitis following spontaneous perforation of pyometra. Case: A 60-year-old postmenopausal woman presented with clinical features of acute abdomen, and she was later diagnosed with pyometra perforation after a computed tomography scan. Laparotomy was performed, followed by a total abdominal hysterectomy with a bilateral salpingo-oopherectomy. Results: The patient died on her third postoperative day. Conclusions: Spontaneous pyometra perforation is a rare clinical condition; yet, it should be suspected and kept in the differential diagnosis of acute abdomen in elderly women. ( J GYNECOL SURG 28:234)

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“…Incidence has been estimated to range from 0.1% to 0.5%. Typically, this is linked to postmenopausal women; however, it has been linked to premenopausal women with concordant use of intrauterine devices [2, 3]. More than 50% of patients with pyometra are asymptomatic; however, if accompanied by impaired drainage via the cervix it can lead to collection of fluid in the uterine cavity and eventual perforation [4].…”

Section: Introductionmentioning

confidence: 99%

Pneumoperitoneum Secondary to Spontaneously Perforated Pyometra

Raymond

Esper

2017

Case Reports in Obstetrics and Gynecology

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Pyometra, by definition, is a collection of purulent fluid within the uterine cavity. Incidence has been estimated to range from 0.1% to 0.5%. Typically, this is linked to postmenopausal women; however, it has been linked to premenopausal women with concordant use of intrauterine devices. Based on our knowledge, there have been less than 50 recorded cases reported in the English literature regarding perforation of pyometra resulting in acute abdomen and fewer than 25 resulting in pneumoperitoneum. We report a patient who was evaluated for diffuse peritonitis caused by perforated pyometra who was successfully treated with surgical intervention.

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Spontaneous rupture of pyometra

Cited by 15 publications

References 3 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: Total Abdominal Hysterectomy

Pneumoperitoneum Secondary to Spontaneously Perforated Pyometra

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