Korean J Obstet Gynecol.  2012 Jun;55(6):437-440. 10.5468/KJOG.2012.55.6.437.

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

• Jeon HS
• Shin HJ
• Kim IH
• Chung H
• Chung DY

• KMID: 1783940
• DOI: http://doi.org/10.5468/KJOG.2012.55.6.437

Abstract

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 significant morbidity and mortality and should be considered in the differential diagnosis of other peritonitis. Preoperative diagnosis of perforated pyometra is difficult 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.

Keyword

Spontaneous uterine perforation; Pyometra; Peritonitis

MeSH Terms

Abdominal Pain
Aged
Cervix Uteri
Diagnosis, Differential
Drainage
Female
Gastrointestinal Diseases
Humans
Peritonitis
Pyometra
Uterine Perforation

Figure

• 

  Fig. 1 Transvaginal ultrasound disclosed an enlarged uterus with loss of endometrial stripe and hypoechoic fluid collection with hyperechoic component in the uterine cavity, suggestive of pyometra.

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  Fig. 2 Contrast-enhanced axial computed tomography images was showing distended endometrial cavity perforation at the fundus.

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  Fig. 3 Intraoperative photograph showed the perforation site in the fundus of the uterus.

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