Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case

Atsunori Nakao, Hisashi Mimura, Kenji Fujisawa, Kazuhiko Ezawa, Takahiro Okamoto, Hiromi Iwagaki, Hiroshi Isozaki, Norihisa Takakura, Noriaki Tanaka

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

We report a rare case of generalized peritonitis due to a ruptured pyometra in an 86-year-old woman, and also conduct a review of the previous Japanese literature. The patient presented with muscle gnarding and rebound tenderness. Computed tomography (CT) disclosed a cystic mass in the peritoneal cavity, in which an air-fluid level was noted. Pneumoperitoneum around the uterus due to gas production of anaerobic bacteria was noted on a CT. At laparotomy, the uterus was markedly enlarged with a necrotic area on the uterine fundus, which was found to be perforated. A supravaginal hysterectomy and drainage were performed. We found only eight cases of a ruptured pyometra presenting as pneumoperitoneum in the Japanese literature between 1977 and 1999. The most common cause of pneumoperitoneum is a perforation of the gastrointestinal tract. However, other possible causes, as seen in our patient, should also be taken into consideration. Although it is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

Original languageEnglish
Pages (from-to)454-457
Number of pages4
JournalSurgery Today
Volume30
Issue number5
Publication statusPublished - 2000

Fingerprint

Pyometra
Pneumoperitoneum
Peritonitis
Uterus
Tomography
Anaerobic Bacteria
Peritoneal Cavity
Acute Pain
Hysterectomy
Laparotomy
Abdominal Pain
Gastrointestinal Tract
Drainage
Gases
Air
Muscles

Keywords

  • Diffuse peritonitis
  • Elderly women
  • Pyometra
  • Rupture of uterus

ASJC Scopus subject areas

  • Surgery

Cite this

Nakao, A., Mimura, H., Fujisawa, K., Ezawa, K., Okamoto, T., Iwagaki, H., ... Tanaka, N. (2000). Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case. Surgery Today, 30(5), 454-457.

Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum : Report of a case. / Nakao, Atsunori; Mimura, Hisashi; Fujisawa, Kenji; Ezawa, Kazuhiko; Okamoto, Takahiro; Iwagaki, Hiromi; Isozaki, Hiroshi; Takakura, Norihisa; Tanaka, Noriaki.

In: Surgery Today, Vol. 30, No. 5, 2000, p. 454-457.

Research output: Contribution to journalArticle

Nakao, A, Mimura, H, Fujisawa, K, Ezawa, K, Okamoto, T, Iwagaki, H, Isozaki, H, Takakura, N & Tanaka, N 2000, 'Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case', Surgery Today, vol. 30, no. 5, pp. 454-457.
Nakao, Atsunori ; Mimura, Hisashi ; Fujisawa, Kenji ; Ezawa, Kazuhiko ; Okamoto, Takahiro ; Iwagaki, Hiromi ; Isozaki, Hiroshi ; Takakura, Norihisa ; Tanaka, Noriaki. / Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum : Report of a case. In: Surgery Today. 2000 ; Vol. 30, No. 5. pp. 454-457.
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