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首页> 外文期刊>Case Reports in Obstetrics and Gynecology >Generalized Peritonitis Secondary to Spontaneous Perforation of Pyometra in a 63-Year-Old Patient
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Generalized Peritonitis Secondary to Spontaneous Perforation of Pyometra in a 63-Year-Old Patient

机译：63岁患者继发于脓疱自发性穿孔后的全身性腹膜炎

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Spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. Herein, we report the case of a 63-year-old woman who presented to emergency department with a 2-day history of severe diffuse abdominal pain, high-grade fever, nausea, and vomiting. Acute abdomen series was done, and upright plain chest radiograph showed free air under diaphragm. A noncontrast-enhanced computed tomography scan showed a significantly distended fluid-filled uterus measuring 10 × 7.8 × 10 cm, in addition to a single focus of perforation involving the uterine fundus and associated with presence of free air within the nondependant area. No evidence of ascites or pelvi-abdominal lymphadenopathy was identified. A preoperative diagnosis of generalized peritonitis secondary to spontaneous perforation of uterus was established. Subsequently, patient underwent urgent exploratory laparotomy which revealed pus-filled uterus with perforated fundus. Diagnosis of generalized peritonitis secondary to spontaneous perforation of pyometra was established. Consequently, patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as thorough drainage and irrigation of pelvi-abdominal cavity. Postoperatively, patient was admitted to intensive care unit. Histopathological examination of uterus was negative for malignancy, and surgical culture grewStreptococcus constellatus. Patient had an uneventful recovery. Moreover, a brief literature review on pyometra is presented.
机译：脓疱疮自发性穿孔导致广泛性弥漫性腹膜炎非常罕见。在此，我们报告了一名63岁的女性，该患者出现在急诊科，有2天的严重弥漫性腹痛，高烧，恶心和呕吐史。进行了急性腹部检查，直立的胸部X光片显示showed下有自由空气。非对比增强计算机断层扫描显示，充盈的子宫充满了大小为10×7.8×10 cm的子宫，此外还有一个单一的穿孔灶涉及子宫底，并且与非独立区域内的自由空气有关。没有发现腹水或盆腹淋巴结肿大的证据。建立了对子宫自发性穿孔继发的广义腹膜炎的术前诊断。随后，患者进行了紧急的探查性剖腹手术，发现其充满脓液的子宫内有穿孔的眼底。建立诊断为脓疱性自发性穿孔继发的广泛性腹膜炎。因此，患者接受了全腹子宫切除术和双侧输卵管卵巢切除术，并彻底引流并冲洗了盆腹腔。术后，患者被送入重症监护室。子宫的组织病理学检查为恶性阴性，并且手术培养物中生长了链球菌。患者恢复良好。此外，对pyometra进行了简要的文献综述。

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