Abstract
A very rare case of spontaneously perforated pyometra is reported.The case is a 89-year-old woman who was admitted to our hospital with the chief complaints of abdominal pain and vomitting.The abdomen was distended and muscular defense and Blumberg sign were noted with WBC count of 28, 600/mm3. These findings showed diffuse peritonitis. Computed tomography of the abdomen revealed a mass in the pelvic cavity, abdominal simple X-ray film revealing no free air. Emergency operation was undertaken under a suspicion of perforation of the alimentary tract or pelvic mass. On lapalotomy a lot of pus and the perforation in the fundus of the distended uterus were found. The patient was diagnosed as uterine perforation assosiating with a pyometra, and total hysterectomy and bilateral salpingoophorectmy were carried out.Histological examination revealed a pyometra with inflammation and destruction of the endometrium and myometrium, and cervical occulusion with no evidence of malignancy. Postoperative course was uneventful and the patient was discharged on the 28th day after surgery.
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