Rare complication of adenomyosis: acute purulent peritonitis and septicaemia in a young nulligravida

K Pushpalatha, Kameshwarachari Pushpalatha, Pushpalatha K, Ruchi Kalra, Singh B, Bharti Singh, Anusha Devalla
BMJ case reports · 2021 · vol. 14(11) , pp. e238374 · doi:10.1136/bcr-2020-238374 · PMID:34844956 · PMC8634357 · W3216942882
article OA: green CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-07, 2026-07-31 ⓘ

This case study documents a rare instance of acute purulent peritonitis and septicaemia in a young nulligravida caused by adenomyosis, requiring hysterectomy and intensive care for recovery.

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Abstract

Adenomyosis is a benign gynaecological condition in multiparous women during their middle age commonly presenting as pelvic pain and menorrhagia. We report a case of a 27-year-old nulligravida of Asian origin from the Indian subcontinent who presented with a huge adenomyotic uterus with mild splenomegaly, and portal cavernoma having gross ascites that developed life-threatening peritonitis and septicaemia. Endometrial aspiration done showed no atypia or malignancy and upper gastrointestinal tract endoscopy done showed no dilated varices. With increasing abdominal distension, she developed tachycardia, tachypnoea, septicaemia and oliguria. Exploratory laparotomy done revealed purulent loculi, omentum and bowel adhesion around the uterus. Adnexa was not distinctly identifiable. Hysterectomy with left salpingo-oopherectomy was performed. She required ventilatory support and intensive unit care postoperatively. Histopathology examination showed adenomyosis with suppuration, right ovary endometriotic cyst and left ovary non-specific inflammation. The patient was discharged in stable condition on day 21. Adenomyosis may rarely occur in young nulligravida women as life-threatening manifestations with purulent peritonitis and septicaemia. Early exploration is crucial for diagnosis and recovery.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Menorrhagia Peritonitis Peritonitis Peritonitis Sepsis Sepsis Adult Female Humans Middle Aged Uterus

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (10)

Cited by (3)

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