⚙
AI-generated deep summary
by claude@2026-06, 2026-06-13
· read from full text
ⓘ
The paper reports a 79-year-old woman in a nursing home who developed fever, difficulty eating, and later vomiting and abdominal pain, progressing to generalized peritonitis with pyometra and shock. After temporary symptom remission with antibiotics, she underwent emergency laparotomy, where a perforated pyometra was found; the authors note a significant drop in blood pressure at anesthesia induction and performed peritoneal lavage plus peritoneal and trans-peritoneal uterine drainage. They state the postoperative course was uneventful and that after trans-vaginal uterine drainage she was discharged without recurrence. The authors contextualize perforated pyometra as rare (54 domestic cases reported in Japan) and discuss that trans-vaginal drainage is typically recommended for non-perforated cases, while total hysterectomy is usually considered for perforated cases, though they suggest additional drainage may be useful in severe cases. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
Abstract
A 79-year-old woman was admitted to the department of internal medicine in our hospital because of fever and difficulty in oral intake. The patinet had paresis for polio and cerebral infarction and was staying at a nurising home. After admission a symptomatic remission was temporarily attained by medical treatment including antibiotics, but these symptoms recurred, accompanied by vomiting and abdominal pain. With close examination, the patient was diagnosed as having generalized peritonitis with pyometra and referred to the department. At the time of arrival, the patient showed poor respiratory and circulatory conditions and was in shock state. On the same day an emergency laparotomy was carried out and a perforated pyometra was found out. Since a significant decrease in blood pressure was noted at time of anesthesia induction, peritoneal lavage and peritoneal and trans-peritoneal uterine drainage were conducted. Postoperative course was uneventful. After trans-vaginal uterine drainage were conducted. Postoperative course was uneventful. After trans-vaginal uterine drainage the patient was discharged from the hospital and there has no been no sign of recurrence. Perforation of pyometra is relatively rare, with 54cases reported in Japan so far. It is common in aged people and so it is often detected after the disease progresses. It has been believed that trans-vaginal uterine drainage is recommended for non-perforated cases and total hysterectomy for perforated cases. But in severe cases like this case, the drainage procedure added by trans-vaginal drainage might be also useful.
Full text
2,236 characters
· extracted from
oa-doi-fallback
· click to expand
A CASE OF PERFORATED PYOMETRA IN AN AGED WOMAN WITH A REVIEW OF DOMESTIC CASES
1998 Volume 59 Issue 6 Pages 1650-1653
Details
Abstract
A 79-year-old woman was admitted to the department of internal medicine in our hospital because of fever and difficulty in oral intake. The patinet had paresis for polio and cerebral infarction and was staying at a nurising home. After admission a symptomatic remission was temporarily attained by medical treatment including antibiotics, but these symptoms recurred, accompanied by vomiting and abdominal pain. With close examination, the patient was diagnosed as having generalized peritonitis with pyometra and referred to the department. At the time of arrival, the patient showed poor respiratory and circulatory conditions and was in shock state. On the same day an emergency laparotomy was carried out and a perforated pyometra was found out. Since a significant decrease in blood pressure was noted at time of anesthesia induction, peritoneal lavage and peritoneal and trans-peritoneal uterine drainage were conducted. Postoperative course was uneventful. After trans-vaginal uterine drainage were conducted. Postoperative course was uneventful. After trans-vaginal uterine drainage the patient was discharged from the hospital and there has no been no sign of recurrence.
Perforation of pyometra is relatively rare, with 54cases reported in Japan so far. It is common in aged people and so it is often detected after the disease progresses. It has been believed that trans-vaginal uterine drainage is recommended for non-perforated cases and total hysterectomy for perforated cases. But in severe cases like this case, the drainage procedure added by trans-vaginal drainage might be also useful.
Perforation of pyometra is relatively rare, with 54cases reported in Japan so far. It is common in aged people and so it is often detected after the disease progresses. It has been believed that trans-vaginal uterine drainage is recommended for non-perforated cases and total hysterectomy for perforated cases. But in severe cases like this case, the drainage procedure added by trans-vaginal drainage might be also useful.
© Japan Surgical Association
Favorites & Alerts
Recently viewed articles
Text is read by the "Ask this paper" AI Q&A widget below.
Extraction quality varies by source — PMC NXML preserves structure
cleanly, OA-HTML may include some navigation residue, and OA-PDF can
have broken hyphenation. The publisher copy
(via DOI)
is the canonical version.