title: Spontaneous perforation of pyometra presenting as acute abdomen: a rare condition with considerable mortality.
abstract: Pyometra is an uncommon and potentially lethal disease that occurs mainly in postmenopausal women. Spontaneous perforation of pyometra presenting as acute abdomen is an extremely rare complication of pyometra, and the patients are always admitted to the emergency department. An additional case is reported herein. In addition, a literature review was performed between 1949 and 2015. A correct preoperative diagnosis was made in 21.05% of all the cases. Of all cases, 25.71% were associated with malignant disease. The mortality rate of spontaneous perforation of pyometra is 31.88%. Thus, it should be considered in the differential diagnosis of acute abdomen in elderly women. Total hysterectomy along with bilateral salpingo-oophorectomy is the preferred treatment. Administration of broad-spectrum antibiotics and postoperative intensive care support are essential to reduce the high mortality.
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China.
authors.forename: Wan-Bin
authors.initials: WB
authors.lastname: Yin
authors.affiliation: Department of Infection, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Wei
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China.
authors.forename: Guang-Wei
authors.initials: GW
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China.
authors.forename: Xiao-Tang
authors.initials: XT
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China.
authors.forename: Mao-Shen
authors.initials: MS
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China.
authors.forename: Ji-Lin
authors.initials: JL
authors.lastname: Hu
authors.affiliation: Animal Laboratory, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
authors.forename: Nan-Yang
authors.initials: NY
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong, China. Electronic address: cloudylucn@126.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010052:Ovariectomy; D055112:Pyometra / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D012422:Rupture, Spontaneous; D058994:Salpingectomy; D007507:Therapeutic Irrigation