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Impending sepsis due to a ruptured pyomyoma with purulent peritonitis: a case report and literature review

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Impending sepsis due to a ruptured

pyomyoma with purulent peritonitis: a case

report and literature review

黃建榮

Yeat SK;Chong KM;Pan HS;Cheng WC;Hwang JL;Lee

CC

摘要

Abstract

Objective

Pyomyoma is an uncommon complication of benign leiomyoma. Here, we report a rare case of a perforated pyomyoma with purulent peritonitis. Case Report

A 53-year-old postmenopausal woman presented with impending septic shock on arrival at our emergency department. Physical examination and imaging studies revealed a pelvic mass with peritonitis. Emergency exploratory

laparotomy due to suspicion of a ruptured pyomyoma or malignancy revealed a spontaneously perforated large pyomyoma leaking copious purulent material directly into the peritoneal cavity. Total hysterectomy and bilateral

salpingo-oophorectomy were performed. Histopathology revealed no

malignancy. The patient recovered smoothly after combined antibiotic therapy. Conclusion

Gynecologists should be aware of this rare emergency condition, especially when handling a patient with a history of leiomyoma uteri and if signs of infection or even sepsis are present.

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