Spontaneous perforated pyometra presenting as pneumoperitoneum

Gynecologic and Obstetric Investigation
Y IkematsuS Kohzaki

Abstract

Spontaneous perforated pyometra presenting as pneumoperitoneum is extremely rare. An 80-year-old Japanese female with spontaneous perforating pyometra presenting as pneumoperitoneum is reported. The patient came to our institute with severe abdominal pain. Routine abdominal examination showed muscular defense, and plain chest roentgenograms revealed infradiaphragmatic free gas. Subsequent computed tomography also demonstrated pneumoperitoneum. Laparotomy was performed on the basis of a tentative diagnosis of perforation of the gastrointestinal tract but revealed a perforated pyometra. A simple hysterectomy was performed. The histological diagnosis of the surgical specimen was acute endometritis without neoplasm. The present report is the third case of spontaneous perforated pyometra with pneumoperitoneum to date. Although uterine disease presenting as pneumoperitoneum is rare in elderly patients with an acute abdomen, the possibility of a perforated pyometra should be considered in the differential diagnosis.

Citations

Nov 10, 2006·Infectious Diseases in Obstetrics and Gynecology·Begüm YildizhanZehra N Kavak
Sep 28, 2013·Case Reports in Obstetrics and Gynecology·Ahmed Abu-ZaidIsmail Al-Badawi
Dec 13, 2006·The American Journal of Emergency Medicine·Chia-Chun TaiKao-Lang Liu
Mar 21, 2016·The Journal of Emergency Medicine·Kaname UnoHidenori Oguchi
Jul 6, 2010·The Journal of Obstetrics and Gynaecology Research·Yu-Che OuChan-Chao ChangChien
Aug 5, 2000·The Australian & New Zealand Journal of Obstetrics & Gynaecology·L K Tan, I Busmanis
Apr 30, 2010·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Ovadia AbulafiaDavid M Sherer

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