Rare complication of adenomyosis: acute purulent peritonitis and septicaemia in a young nulligravida
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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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References (10)
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- Microabscess within adenomyosis combined with sepsis via openalex
- Pyoadenomyosis: A Rare Complication of Adenomyosis via openalex
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Cited by (3)
- Prophylactic antibiotics for preventing pelvic inflammatory disease after embryo transfer in patients with endometriosis: A single-center retrospective cohort study 2026
- Microabscess within adenomyosis combined with sepsis: a report of a rare clinical case 2025
- Adenomyosis with uterine abscess formation treated by adenomyomectomy: A report of two cases 2024
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- europepmc
- last seen: 2026-06-04T01:30:01.192114+00:00
- openalex
- last seen: 2026-06-10T16:23:13.998983+00:00
- pubmed
- last seen: 2026-05-13T22:24:08.918168+00:00
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