We report herein a case of spontaneous perforation of pyometra leading to diffuse peritonitis. This pathological condition is rare, and preoperative diagnosis is difficult. We were able to make the correct diagnosis preoperatively using contrast-enhanced abdominopelvic computed tomography. Both intrauterine and extrauterine fluid collections and defects of the uterine fundus were key findings, and reconstructed sagittal and coronal images were useful. In elderly female patients presenting with acute abdomen, ruptured pyometra should be considered as a possibility.
Pyometra Rupture Perforation CT
This is a preview of subscription content, log in to check access.
Li CH, Chang WC. Spontaneous perforated pyometra with an intrauterine device in menopause: a case report. Jpn J Infect Dis 2008;61:477–478.PubMedGoogle Scholar
Geranpayeh L, Fadaei-Araghi M, Shakiba B. Spontaneous uterine perforation due to pyometra presenting as acute abdomen. Infect Dis Obstet Gynecol 2006;2006:60276.PubMedGoogle Scholar
Yildizhan B, Uyar E, Sismanoglu A, Gulluoglu G, Kavak ZN. Spontaneous perforation of pyometra. Infect Dis Obstet Gynecol 2006;2006:26786.PubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
Hosking SW. Spontaneous perforation of a pyometra presenting as generalized peritonitis. Postgrad Med J 1985;61:645–646.CrossRefPubMedGoogle Scholar
Iwase F, Shimizu H, Koike H, Yasutomi T. Spontaneously perforated pyometra presenting as diffuse peritonitis in older females at nursing homes. J Am Geriatr Soc 2001;49:95–96.CrossRefPubMedGoogle Scholar
Imachi M, Tanaka S, Ishikawa S, Matsuo K. Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer. Gynecol Oncol 1993;50:384–388.CrossRefPubMedGoogle Scholar
Sussman AM, Boyd CR, Christy RS, Rudolph R. Pneumoperitoneum and an acute abdominal condition caused by spontaneous perforation of a pyometra in an elderly woman: a case report. Surgery 1989;105:230–231.PubMedGoogle Scholar
Tsai MS, Wu MH. Images in clinical medicine: pneumoperitoneum due to spontaneously perforated pyometra. N Engl J Med 2006;354:e23.CrossRefPubMedGoogle Scholar
Tan LK, Busmanis I. Spontaneous uterine perforation from uterine infarction: a rare case of acute abdomen. Aust N Z J Obstet Gynaecol 2000;40:210–212.CrossRefPubMedGoogle Scholar