J Menopausal Med.  2016 Apr;22(1):47-49. 10.6118/jmm.2016.22.1.47.

Spontaneous Perforation of Pyometra

Affiliations
  • 1Department of Obstetrics and Gynaecologym, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India. Nalinisharma100@rediffmail.com
  • 2Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
  • 3Department of Radiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Abstract

Pyometra is collection of purulent material which occurs when there is interference with its normal drainage. It is an uncommon condition with incidence of 0.1 to 0.5% of all gynecological patients. Spontaneous rupture of uterus is an extremely rare complication of pyometra. A 65-year-old lady presented with pain abdomen and purulent vaginal discharge. Preoperative diagnosis of pyometra was made by magnetic resonance imaging (MRI). Laparotomy followed by peritoneal lavage and repair of perforation was performed. Although spontaneously perforated pyometra is rare, the condition must be borne in mind with regard to elderly women with acute abdominal pain. Preoperative diagnosis of perforated pyometra is absolutely essential. Computed tomography (CT) and MRI are diagnostic tools. In selected cases conservative approach at surgery can be opted.

Keyword

Peritonitis; Postmenopause; Pyometra; Spontaneous uterine perforation

MeSH Terms

Abdomen
Abdominal Pain
Aged
Diagnosis
Drainage
Female
Humans
Incidence
Laparotomy
Magnetic Resonance Imaging
Peritoneal Lavage
Peritonitis
Postmenopause
Pyometra*
Rupture, Spontaneous
Uterus
Vaginal Discharge

Figure

  • Fig. 1 Pyometra with uterine perforation in anterior wall.

  • Fig. 2 About 1 into 1 cm rent was present on anterior wall of uterus.


Reference

1. Sawabe M, Takubo K, Esaki Y, Hatano N, Noro T, Nokubi M. Spontaneous uterine perforation as a serious complication of pyometra in elderly females. Aust N Z J Obstet Gynaecol. 1995; 35:87–91.
2. Chan LY, Yu VS, Ho LC, Lok YH, Hui SK. Spontaneous uterine perforation of pyometra. A report of three cases. J Reprod Med. 2000; 45:857–860.
3. Inui A, Nitta A, Yamamoto A, Kang SM, Kanehara I, Tanaka H, et al. Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: report of a case. Surg Today. 1999; 29:935–938.
4. Saha PK, Gupta P, Mehra R, Goel P, Huria A. Spontaneous perforation of pyometra presented as an acute abdomen: a case report. Medscape J Med. 2008; 10:15.
5. Yildizhan B, Uyar E, Sişmanoğlu A, Güllüoğlu G, Kavak ZN. Spontaneous perforation of pyometra. Infect Dis Obstet Gynecol. 2006; 2006:26786.
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