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Infectious Diseases in Obstetrics and Gynecology
Volume 2006 (2006), Article ID 60276, 2 pages
Case Report

Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

1Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran 14155-6537, Iran
2Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 14155-6537, Iran

Received 18 January 2006; Accepted 28 February 2006

Copyright © 2006 Loabat Geranpayeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Spontaneous perforation of the uterus is rare, its incidence being about 0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.