2018 Volume 38 Issue 3 Pages 559-561
We report herein on an unusual case of pyometra, an intrauterine pus collection, which presented as a strangulated inguinal hernia. An 88-year-old woman with a high fever and swelling of the right inguinal region went to her family physician who suspected the presence of a strangulated inguinal hernia and referred her to our hospital. Physical examination revealed right inguinal swelling with pain and redness, but no tenderness in the abdomen. Laboratory findings were unremarkable except an elevated level of C-reactive protein and an increased white blood cell count. Enhanced computerized tomography （CT） showed an abscess 6cm in diameter in the right pelvis and another which was 8cm in the right inguinal region. There was also communication between the two abscesses and a fistula in the retroperitoneum cavity. We made the diagnosis of a perforation of pyometra into the retroperitoneal cavity, which spread into the inguinal region. Drainage of both abscesses was conducted and bacteriological cultures were positive for Streptococcus constellatus. The post-drainage course was good, and the patient was discharged without the necessity for a hysterectomy.
