Spontaneous perforation of a pyometra presenting as generalized peritonitis

Hosking, S. W.

doi:10.1136/pgmj.61.717.645

Cited by 16 publications

(9 citation statements)

References 4 publications

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“…Patients with severe comorbidities cannot withstand the operative stress because spontaneous rupture of pyometra is associated with the development of septic shock or disseminated intravascular coagulation. One patient died because of myocardial infarction during surgery [14]. Physicians must pay attention to comorbidities in patients in whom spontaneous rupture of pyometra is diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…We collected data from 47 patients diagnosed with spontaneous rupture of pyometra between 1949 and 2011 [2,3,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40]. The available literature was carefully reviewed, and our patients' descriptions were included to evaluate the characteristics related to outcomes in cases of spontaneous rupture of pyometra.…”

Section: Methodsmentioning

confidence: 99%

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Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Ikeda

Takahashi

Kurachi

2013

Gynecol Obstet Invest

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Background/Aims: The spontaneous perforation of pyometra is very rare and is associated with a poor prognosis. The present study aimed to evaluate the clinical characteristics and prognostic factors for patient survival. Patients and Methods: We reported on 7 patients with spontaneous rupture of pyometra. We also reviewed 47 additional published cases. Thus, all 54 patients were analyzed for mortality. Results: We investigated the prognosis in 44 of 54 patients, excluding 8 patients with undocumented outcome and 2 who died of other diseases. The mortality rate was 25% (11 of 44). In univariate analysis, variables such as age, correct preoperative diagnosis, comorbidities, the presence of malignancy, and hysterectomy were not significant between surviving and deceased patients. In bacterial cultures from the peritoneal cavity, the most common etiological organisms were Escherichia coli and anaerobes such as Bacteroides and Peptococcus species. The rate of isolation of anaerobic bacteria was significantly increased in patients who died (odds ratio, 6.33; 95% confidence interval, 1.28-31.02; p = 0.04). Conclusion: Antibiotic therapy for E. coli and anaerobes should be considered in patients with spontaneous perforation of pyometra.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Ikeda

Takahashi

Kurachi

2013

Gynecol Obstet Invest

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“…Other conditions disposing to pyometra are vaginal repair operations [1,2,7], benign tumors of the cervix [1,4], previous radiation of pelvic organs [1,6] or extragenital cancers invading the cervix [1,3,4]. Occasionally no underlying disease can be found [3,7].…”

Section: Discussionmentioning

confidence: 99%

“…A pyometra usually drains through the cervix [4,6]. Rarely, it may burst through an area of weakness, e.g.…”

Section: Discussionmentioning

confidence: 99%

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Perforation of a pyometra mimicking a perforated peptic ulcer

Rasmussen

Luckow

1991

Arch Gynecol Obstet

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Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: Report of a case

et al. 1999

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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.

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Spontaneous perforation of a pyometra presenting as generalized peritonitis

Cited by 16 publications

References 4 publications

Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Spontaneous Perforation of Pyometra: A Report of Seven Cases and Review of the Literature

Perforation of a pyometra mimicking a perforated peptic ulcer

Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: Report of a case

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