1/8. Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: report of a case.Spontaneous perforation is a very rare complication of pyometra. We report herein the case of an 88-year-old woman who presented with muscular rigidity and free air on abdominal X-ray films. Perforation of the gastrointestinal tract was diagnosed preoperatively, and an emergency laparotomy was performed. A total hysterectomy with bilateral salpingo-oophorectomy was carried out under the diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra. The culture of purulent fluid from the abdominal cavity showed only escherichia coli, with no anaerobic bacteria. Histological examination revealed pyometra with necrosis of the endometrium and no evidence of malignancy. The patient was discharged on postoperative day 68 without any major complications. pyometra is an unusual cause of peritonitis, but it must be considered as a possible diagnosis in elderly women presenting with an acute abdomen. Following this case report, we discuss the problems associated with establishing a correct preoperative diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/8. Spontaneous uterine perforation from uterine infarction: a rare case of acute abdomen.A case of spontaneous uterine perforation from uterine infarction is presented. The authors believe that this is the first reported case.- - - - - - - - - - ranking = 4keywords = abdomen (Clic here for more details about this article) |
3/8. Spontaneous uterine perforation of pyometra. A report of three cases.BACKGROUND: Spontaneous perforation of pyometra is a rare cause of generalized peritonitis; only 17 cases have been reported. CASES: Three cases of spontaneous perforation of pyometra occurred; two were associated with carcinoma of the cervix. All were treated with exploratory laparotomy and drainage. The first patient died of recurrent carcinoma of the cervix five months after laparotomy. The second patient died of septic shock shortly after the operation. The third patient made a good postoperative recovery. CONCLUSION: pyometra is a serious medical condition, because of both its association with malignant disease and the danger of spontaneous perforation, which carries significant morbidity and mortality. Although rare, ruptured pyometra should be considered in the differential diagnosis of acute abdomen in elderly women, especially those with malignant disorders of the genital tract. The treatment of pyometra rupture is immediate laparotomy, peritoneal lavage and drainage, or simple hysterectomy.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
4/8. A lost intrauterine device. Guess where we found it and how it happened?Perforation of the uterus by an intrauterine device (IUD) is a serious complication occurring at or following 1/350 to 1/2,500 insertions. It is more common among women with 'lost' IUDs. If a woman presents with pelvic pain and a history of a 'lost' IUD, x-rays of the abdomen and of the pelvis should be ordered. We report on a 'lost' IUD that had been inserted 12 years previously. It was found in the lower anterior abdominal wall. Most probably uterine perforation had happened during a dilatation and curettage (D & C) attempted for removal of the device. Thereafter the IUD must have migrated to the abdominal wall. This case illustrates that unless it can be recovered by simple traction on the threads, a trained medical professional should be called upon for removal of the IUD.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
5/8. Computed tomography features of spontaneously perforated pyometra: a case report.Spontaneous perforation of pyometra is an extremely rare emergent gynecologic disease. We report a 73-year-old woman with a spontaneously perforated pyometra presenting with acute abdomen in the emergency department. A dedicated computed tomography examination of the abdominal and pelvic regions revealed the diagnosis. The patient recovered well after surgical intervention and antibiotic treatment.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
6/8. A case report of unusual complication of myomatous uterus in pregnancy: spontaneous perforation of myoma after red degeneration.An unusual complication of myomatous uterus in pregnancy is presented. It shows spontaneous perforation of a myoma after red degeneration, presenting as an acute abdomen. To our knowledge spontaneous perforation of a necrotising leiomyoma has not been reported earlier. A review of the literature is given.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
7/8. Spontaneously perforated pyometra. A differential diagnosis in acute abdomen.Spontaneously perforated pyometra is rare, but the condition must be born in mind in women with acute abdomen. Two cases are reported, one resembling perforated peptic ulcer, the other was mistaken for acute appendicitis.- - - - - - - - - - ranking = 5keywords = abdomen (Clic here for more details about this article) |
8/8. Spontaneous perforated pyometra presenting as pneumoperitoneum.BACKGROUND: Spontaneous perforated pyometra presenting as pneumoperitoneum is extremely rare. CASE REPORT: 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. CONCLUSION: 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.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |