2017 Volume 42 Issue 1 Pages 73-77
A 66-year-old female was transferred to our hospital with lower abdominal pain. Computed tomography revealed free-air spots on the peritoneum and in the uterus with an abnormal thickening of the sigmoid colon. Peritoneal and uterus perforations caused by sigmoid tumor were diagnosed. Therefore, an emergent surgery was planned. On performing laparotomy, it was observed that white infectious ascites leaked from the pelvis. Sigmoid colon tumor had adhered tightly to the uterus, and the uterus was perforated. Supravaginal amputation of the uterus, bilateral salpingo-oophorectomy, sigmoid colectomy, and D3 lymph node dissection were performed. Final diagnosis was acute disseminated peritonitis from uterine perforation in pyometra caused by sigmoid colon adenocarcinoma. No gynecological malignancy was found in the uterus. Pyometra generally occurs in elderly people and is caused by excretion disorder of the uterus cavity secretions. In our patient, the sigmoid colon adenocarcinoma had tightly adhered to the uterus and elicited excretion disorder; then, pyometra occurred in the uterus. The patient had left the pyometra; thereby argent peritonitis occurred due to uterus perforation in pyometra.
