title: Spontaneously perforated pyometra: an unusual cause of acute abdomen and pneumoperitoneum.
abstract: Pneumoperitoneum is usually associated with gastrointestinal perforation or following surgical and endoscopic procedures. We report a rare case of spontaneously perforated pyometra presenting with generalised peritonitis and pneumoperitoneum. Perforation of the uterus is also unusual  and often associated with the presence of an intrauterine device, a gravid uterus or malignancy. Our case illustrates the importance of clinical knowledge of acute and neoplastic gynaecological diseases, which are not uncommonly encountered by the general surgeon. Moreover, good appreciation  of pelvic anatomy and close collaboration with gynaecology colleagues is essential as operative intervention is often required.
authors.affiliation: Department of General Surgery, Tameside General Hospital, Fountain Street, Ashton-under-Lyne OL6 9RW, UK. i.m.shapey@doctors.org.uk
authors.forename: I M
authors.initials: IM
authors.lastname: Shapey
authors.forename: T
authors.initials: T
authors.lastname: Nasser
authors.forename: P
authors.initials: P
authors.lastname: Dickens
authors.forename: M
authors.initials: M
authors.lastname: Haldar
authors.forename: M H
authors.initials: MH
authors.lastname: Solkar
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D011027:Pneumoperitoneum / Q000209:etiology*; D055112:Pyometra / Q000150:complications*; D012422:Rupture, Spontaneous / Q000150:complications; D018805:Sepsis / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014595:Uterine Perforation / Q000150:complications*