Uterine Perforation in Postmenopausal Woman – Case Report (original) (raw)
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Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen
Infectious Diseases in Obstetrics and Gynecology, 2006
Spontaneous perforation of the uterus is rare, its incidence being about0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.
Peritonitis as a Result of Spontaneous Rupture of Uterus due to Pyometra: A Diagnostic Dilemma
2015
Peritonitis as a result of spontaneous rupture of the uterus due to pyometra is a very rare entity. Since 1980, only a few cases of spontaneous rupture of the uterus due to pyometra have been reported in the literature. It is a diagnostic dilemma for a surgeon and a possibility of this entity though very rare should be borne in mind in an elderly female patient with diffuse peritonitis as outcome improves greatly on timely diagnosis and proper management. We present a case of peritonitis due to spontaneous rupture of the uterus due to pyometra which was diagnosed at laparotomy and managed successfully.
Spontaneous Ruptured Pyometra: A Gynaecological Emergency
Bangladesh Journal of Obstetrics & Gynaecology, 2019
Pyometra is a condition characterized by the accumulation of pus within the uterine cavity that usually develops in elderly women . Spontaneous rupture of pyometra causing diffuse peritonitis is very rare.Unless recognized in time it can be a life threatening condition. The aim of this article is to report a case of spontaneous rupture of pyometra who was admitted in our hospital as surgical emergency and was successfully treated by surgery. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 48-51
Postmenopausal spontaneous rupture of pyometra
Medicine, 2018
Rationale: The incidence of spontaneous perforations in pyometra occurs rarely, only 0.01% to 0.5% in gynecological patients, with high mortality and morbidity. The clinical manifestation of perforated uterine pus is similar to that of gastrointestinal perforation, but the gynecological symptoms are not so obvious, which makes preoperative diagnosis difficult. Here, we report a rare case of peritonitis with laparotomy of pyometra. Patient concerns: An acute abdominal pain and purulent vaginal discharge developed in a 72-year-old woman who underwent an emergency laparotomy because of signs of diffuse peritonitis and in a state of shock. Diagnoses: We made a diagnosis of spontaneous perforation of pyometra. Interventions: At laparotomy, about 1000 mL of pus with the source of uterine was found in the abdominal cavity, while gastrointestinal tract was intact and a crevasse with a diameter of 1.5 cm on posterior uterine wall was obvious. A total abdominal hysterectomy and a bilateral salphingo oophorectomy were performed. Outcomes: The patient got discharged on 34th postoperative hospitalization day with only 1 complication of wound healing. Histopathological study revealed uterine purulent inflammation, with no evidence of malignancy. Lessons: Ultrasonography is the first and most sensitive examination for the evaluation of pyometra, but has limited role in the diagnosis of perforated pyometra. Additional diagnostic radiographic evaluation use for acute abdomen is total abdomen computed tomography scan and magnetic resonance imaging techniques of female pelvis.
Spontaneous Perforation of Pyometra: Total Abdominal Hysterectomy
Journal of Gynecologic Surgery, 2012
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)
A rare case of peritonitis following spontaneous rupture of Pyometra
Journal of Basic and Clinical Reproductive Sciences, 2012
Pyometra is the accumulation of pus in the uterine cavity. The reported incidence varies from 0.5% in young patients to 13.6% in elderly patients attending gynecological clinic. It is a common complication of malignancy of cervix and uterine body. The cause of pyometra is the occlusion of cervical canal by benign or malignant growth, stenosis following age-related atrophy, radiation treatment, or surgery on the cervix. A spontaneous rupture of pyometra causing diffuse peritonitis is very rare, with reported incidence of 0.01% to 0.5% in elderly women. Unless recognized in time, it can be a life-threatening condition. We present a case of 65-year-old woman who presented with this rare and life-threatening complication. She was treated by emergency exploratory laparotomy. Total abdominal hysterectomy with bilateral salpingo ophorectomy was performed. Patient had uneventful postoperative period.
Spontaneous Perforation of Pyometra
Infectious Diseases in Obstetrics & Gynecology, 2006
Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01-0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy). Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.
Case Reports in Radiology, 2016
Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct a...
Spontaneous perforation of pyometra in an elderly woman: a case report
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012
Pyometra is an uncommon gynecologic condition that usually develops in elderly women. Most of the cases result from cervical occlusion by malignant or benign tumors, surgery, radiotherapy, or atrophic cervicitis. A spontaneous perforation of the uterus with generalized peritonitis is an extremely rare complication of pyometra and carries significant morbidity and mortality. Establishing a correct diagnosis preoperatively is not easy due to the non-specificity of the symptoms. The authors present a case report of peritonitis caused by spontaneously perforated pyometra that was diagnosed intraoperatively. The cervical canal was not occluded and the cause of perforation remains obscure.