Spontaneous perforation of pyometra: A rare cause of diffuse peritonitis

Chauhan, Ashutosh; Sharma, Mala Mathur; Banerjee, Jayanta

doi:10.1016/j.mjafi.2012.08.012

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…In order to rule out related cancers, a thorough history and clinical examination should be performed after the diagnosis has been made. It is a significant medical disorder with potential life-threatening implications like spontaneous uterine perforation [2]. Prognosis in cases of perforated pyometra is variable.…”

Section: Discussionmentioning

confidence: 99%

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Massive Pyometra Due to Senile Endometritis in a Postmenopausal Woman: A Rare Entity

Waghe¹,

Acharya²,

Potdar³

et al. 2022

Cureus

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An 83-year-old postmenopausal female P5L5 (all full-term normal deliveries) presented with complaints of foul-smelling purulent discharge per vagina for 15 days associated with pain in abdomen. A midline mass was palpable per abdomen in the suprapubic region corresponding to 16 weeks size gravid uterus, which was soft to firm in consistency. On examination per vaginum, the atrophied cervix was found flush with the vagina and purulent discharge was seen draining through the cervix. Blood reports showed raised total leucocyte count with granulocyte predominance. Abdominal ultrasonography revealed a uterine cavity filled with echogenic contents, with no abdominal cavity collection. The patient was started on IV antibiotics and planned for dilatation and curettage. On histopathology acute on chronic senile endometritis was found with no evidence of malignant cells. Tuberculosis gene testing was found to be negative. We conclude that the senile endometritis leading to cervical stenosis as seen during dilatation and curettage had led to the pyometra and no evidence of malignancy was found.

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Section: Discussionmentioning

confidence: 99%

“…In older patients, the incidence rises with age and is 13.6%. A study by Chauhan A et al shows the median age of presentation to be 65 years, and only less than one-third of cases are linked to an underlying malignancy [2]. Some other causes of such huge pyometra may be foreign bodies, puerperal infections, and uterine anomalies [3].…”

Section: Introductionmentioning

confidence: 99%

Massive Pyometra Due to Senile Endometritis in a Postmenopausal Woman: A Rare Entity

Waghe¹,

Acharya²,

Potdar³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…Patients with immunocompromising chronic diseases-including renal failure, diabetes mellitus, and steroid users-are particularly vulnerable to uterine abscess [8]. Although accurate diagnosis, early intervention, and proper management can lower the morbidity of pyometra, it can be a life-threatening disease in certain cases [9]. If fluid collection inside the uterus without perforation is observed via transvaginal ultrasound, it can be managed by draining the uterine cavity through the cervical canal.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Pyometra: Eleven Years of Experience from a Single Institution

Ouh¹,

Oh²,

Hong³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: Pyometra is defined as an accumulation of purulent material in the uterine cavity. It is caused by natural drainage impairment within the cervix and occurs predominantly in elderly women. In this study, we aimed to investigate the clinical characteristics and recurrent risk of pyometra. Methods: Data for patients diagnosed with pyometra between 2010 and 2021 were retrospectively reviewed. Basic patient characteristics, including age, underlying disease, management, chief complaint, antibiotics, and isolated organisms, were investigated. The risk of recurrence of pyometra was assessed using multivariate logistic regression analyses. In total, 65 patients with pyometra were included in this study. Results: The mean age of the patients was 75.8 ± 16.4 years. About half of the patients had been admitted to a nursing hospital due to poor mobility, and 61.5% of the patients had an Eastern Cooperative Oncology Group performance score of 2 or higher. The most prevalent presenting symptoms were vaginal discharge (73.9%) and fever (16.9%). Forty-eight (75.0%) patients underwent drainage, and seven (10.9%) underwent hysterectomy. Escherichia coli accounted for the most cases (36.9%), followed by Klebsiella pneumoniae (20.0%). Overall, 17 patients were extended-spectrum β-lactamase positive. Recurrence after drainage occurred in 16 (24.6%) of the 65 patients, and two patients died from septic shock. The isolation of Klebsiella pneumoniae was identified as a significant risk factor for recurrence (odds ratio (OR): 4.71; 95% confidence interval (CI): 1.09-20.47; p < 0.05). Conclusions: Because pyometra often occurs in elderly patients with chronic diseases, it is important to pursue appropriate treatment and prevention of recurrence to decrease the morbidity and mortality associated with this condition. The isolated organisms should be considered as a predisposing factor for recurrent pyometra.

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“…Median age of presentation is 65 years and less than one-third cases are associated with underlying malignancy. 2 Other causes being foreign bodies, puerperal infections or uterine anomalies. 3 However, it is thought to be relatively rare in the premenopausal age group.…”

Section: Introductionmentioning

confidence: 99%