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Title: PYOMETRA : THE HIDDEN CATASTROPHE- A RARE CASE OF SPONTANEOUS PERFORATION OF PYOMETRA IN A CERVICAL CARCINOMA PATIENT
e-poster Number: EP 347
Category: Gynecologic Oncology
Author Name: Dr. Chetana Patil
Institute: Rajarajeshwari medical college
Co-Author Name:
Abstract :
Introduction ?
Pyometra is defined as accumulation of purulent material /pus in the uterine cavity .
It is commonly seen in post menopausal women .The condition is often associated with malignant causes such as cervical carcinoma,endometrial carcinoma and benign causes like congenital cervical stenosis .
The aforementioned etiological factors lead to the accumulation of purulent material within the uterine cavity, accompanied by cervical stenosis, which obstructs the outlet. This obstruction results in the continued buildup of pus and progressive thinning of the uterine walls, ultimately culminating in spontaneous uterine perforation.In post menopausal women gynaecological malignancy is to be considered as the main culprit until proven other wise .
Pathogenically pyometra is polymicrobial in nature and involves both aerobic and anaerobic microbes such as Ecoli, streptococcus.Clinically spontaneous perforation may present with features of peritonitis ,pain abdomen ,vomiting ,fever .There is no definitive symptom hence making it a diagnostic conundrum.An early diagnosis plays pivotal role in decreasing the rates of spontaneous perforation.
Case study: We are reporting a case of 60 year old post menopausal female ,P7L7 with k/c/o HTN with T2DM on treatment with spontaneous perforation of uterus .
Patient underwent exploratory laparotomy with Total abdominal hysterectomy with b/l salpingo -ophorectomy
Conclusion:
The preoperative diagnosis of pyometra presents a significant diagnostic challenge; however, it is crucial for timely intervention. Early identification can mitigate the risk of uterine rupture and facilitate the detection of potential underlying etiologies, including malignancy.
