On rare pyometra caused by perforation in 1 case.docVIP

 PAGE \* MERGEFORMAT 7 On rare pyometra caused by perforation in 1 case [Abstract] reviewed a cause of uterine perforation in patients with empyema after treatment, thereby postmenopausal elderly women with acute abdominal pain should raise awareness, vigilance pyometra peritonitis caused by perforation of the disease, attention and gastrointestinal perforation phase identification, in order to strengthen prevention, B-in the diagnosis of this disease has important diagnostic reference value. [Keywords:] pyometra; perforation; B ultrasonic diagnosis Patients, female, 74 years, mainly due to 4h before the sudden appearance of abdominal pain after eating, and quickly spread to the whole abdominal pain, pain was sustained, with nausea and vomiting, without any treatment of acute and come to the hospital. Previous physical health, pregnancy 5 products 5,47-year-old post-menopausal, no history of irregular bleeding. Physical examination: T 38.4 ℃, P 88 times / min, BP 140/70mmHg, Shen Qing, face pain, heart and lungs were normal, slightly bulging belly, whole abdominal tenderness, rebound tenderness, muscular tension, as the middle of the following abdominal, beating the drum sound, moving cloud (+). B-show: the equivalent of uterus wall can be seen about 6cm × 5.4cm thick liquid dark area, and cervical connected to the sound through poor visibility around the thick 2.7cm liquid dark area, diagnosis: pelvic liquid mass (uterine perforation?); peritoneal dialysis fluid, see a small amount of small intestinal pneumatosis, no obvious fluid level. routine blood test showed: WBC 18.8 × 109 / L, N 89.9% , L 8%. Line abdominal paracentesis in emergency department out of cream cloudy ascites, pus full vision examination, to be attending the initial diagnosis of abdominal pain (gastrointestinal perforation?), Diffuse peritonitis income of general surgery, to be anti-inflammatory treatment is ineffective, laparotomy surgery. intraoperative intraperitoneal pus s