caa a22 4500 475753747 CHVBK 20180406123532.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s005950050624 doi (NATIONALLICENCE)springer-10.1007/s005950050624 Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: Report of a case [Elektronische Daten] [Atsunori Nakao, Hisashi Mimura, Kenji Fujisawa, Kazuhiko Ezawa, Takahiro Okamoto, Hiromi Iwagaki, Hiroshi Isozaki, Norihisa Takakura, Noriaki Tanaka] We report a rare case of generalized peritonitis due to a ruptured pyometra in an 86-year-old woman, and also conduct a review of the previous Japanese literature. The patient presented with muscle guarding and rebound tenderness. Computed tomography (CT) disclosed a cystic mass in the peritoneal cavity, in which an air-fluid level was noted. Pneumoperitoneum around the uterus due to gas production of anaerobic bacteria was noted on a CT. At laparotomy, the uterus was markedly enlarged with a necrotic area on the uterine fundus, which was found to be perforated. A supravaginal hysterectomy and drainage were performed. We found only eight cases of a ruptured pyometra presenting as pneumoperitoneum in the Japanese literature between 1977 and 1999. The most common cause of pneumoperitoneum is a perforation of the gastrointestinal tract. However, other possible causes, as seen in our patient, should also be taken into consideration. Although it is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain. Springer-Verlag, 2000 diffuse peritonitis nationallicence pyometra nationallicence rupture of uterus nationallicence elderly women nationallicence Nakao Atsunori Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut Mimura Hisashi Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut Fujisawa Kenji Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut Ezawa Kazuhiko Department of Internal Medicine, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut Okamoto Takahiro First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut Iwagaki Hiromi First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut Isozaki Hiroshi First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut Takakura Norihisa First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut Tanaka Noriaki First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut Surgery Today Springer-Verlag 30/5(2000-05-01), 454-457 0941-1291 30:5<454 2000 30 595 https://doi.org/10.1007/s005950050624 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950050624 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakao Atsunori Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Mimura Hisashi Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Fujisawa Kenji Department of Surgery, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Ezawa Kazuhiko Department of Internal Medicine, Kurashiki Kosai Hospital, 5-4-16 Higashizuka, 712-8044, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Okamoto Takahiro First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut NATIONALLICENCE 700 1- Iwagaki Hiromi First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut NATIONALLICENCE 700 1- Isozaki Hiroshi First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut NATIONALLICENCE 700 1- Takakura Norihisa First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut NATIONALLICENCE 700 1- Tanaka Noriaki First Department of Surgery, Okayama Medical School, 2-5-1 Shikata-cho, 700-8558, Okayama City, Okayama, Japan aut NATIONALLICENCE 773 0- Surgery Today Springer-Verlag 30/5(2000-05-01), 454-457 0941-1291 30:5<454 2000 30 595 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer