A Case of Panperitonitis Due to Perforation of Pyometra

Abstract

Herein, we report a case of panperitonitis caused by spontaneous perforation of pyometra. The patient, a 66-year-old woman, was transferred to our hospital after being diagnosed as having gastrointestinal perforation with panperitonitis. Abdominal computed tomography（CT）at admission to our hospital revealed free air and fluid collection in her upper abdomen, confirming, the diagnosis, and an emergency laparotomy was performed. Intraoperatively, the perforation was identified in the fundus of the uterus rather than in the bowel. Based on the diagnosis of panperitonitis caused by perforation of pyometra, procedures including hysterorrhaphy, peritoneal irrigation, and transvaginal abdominal drainage were performed, and the patient recovered. Radical hysterectomy, bilateral salpingo-oophorectomy, and retroperitoneal lymph node dissection were performed subsequently on the 121st postoperative day. In conclusion, the two-stage surgery allowed for the patient’s life to be saved first, and then, treatment of the remaining symptoms.