2022
DOI: 10.1093/jscr/rjac388
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Spontaneous perforation of pyometra—is hysterectomy required in the emergent setting? A case report and literature review

Abstract: Spontaneous perforation of pyometra is a rare event associated with significant morbidity and mortality when diffuse peritonitis is present. While malignant lesions of the cervical tract are the most common cause of pyometra, several benign conditions can contribute to this diagnosis. Traditionally hysterectomy has been the surgical approach of choice for this clinical entity; however, in the setting of septic shock, temporizing techniques may offer the opportunity to stabilize patients and complete a thorough… Show more

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Cited by 7 publications
(9 citation statements)
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“…Pyometra is defined as a chronic inflammatory process of the endometrium with the accumulation of purulent exudates in the uterine cavity caused by interference with its natural drainage. [1] It is an uncommon condition with a reported incidence ranging from 0.1% to 0.5% and an incidence approaching 13.6% in postmenopausal women [1,2,3] It is associated with benign or malignant gynecological tumors, colorectal tumors, radiation cervicitis, congenital anomalies, puerperal infections and intrauterine devices. [4] Pyometra develops gradually and with progression it will lead to enlargement of the uterus, causing degenerative changes that may rarely lead to sloughing of the uterine wall with subsequent spillage of contents into the abdominal cavity.…”
Section: Introductionmentioning
confidence: 99%
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“…Pyometra is defined as a chronic inflammatory process of the endometrium with the accumulation of purulent exudates in the uterine cavity caused by interference with its natural drainage. [1] It is an uncommon condition with a reported incidence ranging from 0.1% to 0.5% and an incidence approaching 13.6% in postmenopausal women [1,2,3] It is associated with benign or malignant gynecological tumors, colorectal tumors, radiation cervicitis, congenital anomalies, puerperal infections and intrauterine devices. [4] Pyometra develops gradually and with progression it will lead to enlargement of the uterus, causing degenerative changes that may rarely lead to sloughing of the uterine wall with subsequent spillage of contents into the abdominal cavity.…”
Section: Introductionmentioning
confidence: 99%
“…[5] Pyometra with accompanying necrosis of the uterine wall can lead to spontaneous uterine perforation with diffuse peritonitis, with a reported incidence of 0.01-0.05%. [1] Pneumoperitoneum is seen in hollow viscus perforation, and penetrating trauma, after laparotomy and laparoscopy. However, pneumoperitoneum in a case of uterine perforation is a very rare presentation.…”
Section: Introductionmentioning
confidence: 99%
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“…Pyometra is the accumulation of purulent material in the uterine cavity secondary to inability to adequately drain the uterine cavity. 1 It is a rare condition with a reported incidence between 0.1% to 0.5%. This incidence reaches up to 13.6% in postmenopausal women.…”
Section: Introductionmentioning
confidence: 99%
“…This incidence reaches up to 13.6% in postmenopausal women. 1,2 Uterine perforations is rare due to rich vascular supply of uterus. Pyometra develops gradually and with progression it will lead to enlargement the uterus, causing degenerative changes that may rarely lead to sloughing of the uterine wall with subsequent spillage of contents into the abdominal cavity.…”
Section: Introductionmentioning
confidence: 99%