{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:12:56Z","timestamp":1780409576401,"version":"3.54.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Spontaneous perforation of pyometra is a rare event associated with significant morbidity and mortality when diffuse peritonitis is present. While malignant lesions of the cervical tract are the most common cause of pyometra, several benign conditions can contribute to this diagnosis. Traditionally hysterectomy has been the surgical approach of choice for this clinical entity; however, in the setting of septic shock, temporizing techniques may offer the opportunity to stabilize patients and complete a thorough work up before committing to definitive resection. This report explores a case of septic shock secondary to spontaneous perforation of pyometra that was definitively managed with peritoneal lavage and wide drainage. Intraoperative hysteroscopy and uterine biopsy were performed, and no malignancy was identified on final pathology. Intraoperative hysteroscopy along with peritoneal lavage and wide drainage may reduce the morbidity and mortality associated with sepsis from spontaneous perforation of pyometra and potentially avoid unnecessary hysterectomy.<\/jats:p>","DOI":"10.1093\/jscr\/rjac388","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T22:38:13Z","timestamp":1661899093000},"source":"Crossref","is-referenced-by-count":14,"title":["Spontaneous perforation of pyometra\u2014is hysterectomy required in the emergent setting? A case report and literature review"],"prefix":"10.1093","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-7254","authenticated-orcid":false,"given":"Ikennah L","family":"Browne","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Calgary, Cumming School of Medicine , Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"2022083022380272000_ref1","doi-asserted-by":"crossref","first-page":"26786","DOI":"10.1155\/IDOG\/2006\/26786","article-title":"Spontaneous perforation of pyometra","volume":"2006","author":"Yildizhan","year":"2006","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2022083022380272000_ref2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ejogrb.2017.08.042","article-title":"Spontaneous uterine rupture due to pyometra, a case report","volume":"217","author":"Emergui Zrihen","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2022083022380272000_ref3","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1447-0756.2010.01184.x","article-title":"Clinical characteristics of perforated pyometra and impending perforation: specific issues in gynecological emergency","volume":"36","author":"Ou","year":"2010","journal-title":"J Obstet Gynaecol Res"},{"key":"2022083022380272000_ref4","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000013659","article-title":"Postmenopausal spontaneous rupture of pyometra: a case report","volume":"97","author":"Huang","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"2022083022380272000_ref5","first-page":"1738521","article-title":"Spontaneous rupture of pyometra causing peritonitis in elderly female diagnosed on dynamic transvaginal ultrasound","volume":"2016","author":"Malvadkar","year":"2016","journal-title":"Case Rep Radiol"},{"key":"2022083022380272000_ref6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5387\/fms.2019-30","article-title":"Generalized peritonitis secondary to spontaneously perforated pyometra in elderly women:two cases with different clinical courses and surgical approaches and review of the literature","volume":"66","author":"Yazawa","year":"2020","journal-title":"Fukushima J Med Sci"},{"key":"2022083022380272000_ref7","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1159\/000291980","article-title":"Spontaneous perforated pyometra presenting as pneumoperitoneum","volume":"42","author":"Ikematsu","year":"1996","journal-title":"Gynecol Obstet Invest"},{"key":"2022083022380272000_ref8","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3109\/01443615.2015.1072809","article-title":"Uterine perforation of pyometra in a cervical cancer: a case report and literature review","volume":"36","author":"Konishi","year":"2016","journal-title":"J Obstet Gynaecol"},{"key":"2022083022380272000_ref9","doi-asserted-by":"crossref","DOI":"10.1002\/ams2.657","article-title":"Damage control surgery for spontaneous perforation of pyometra with septic shock: a case report","volume":"8","author":"Matsumoto","year":"2021","journal-title":"Acute Med Surg"},{"key":"2022083022380272000_ref10","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4103\/ijnmr.IJNMR_146_20","article-title":"Iranian Women's self-concept after hysterectomy: a qualitative study","volume":"26","author":"Goudarzi","year":"2021","journal-title":"Iran J Nurs Midwifery Res"},{"key":"2022083022380272000_ref11","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/j.1365-2702.2011.03913.x","article-title":"Separation, failure and temporary relinquishment: women's experiences of early mothering in the context of emergency hysterectomy","volume":"21","author":"Elmir","year":"2012","journal-title":"J Clin Nurs"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2022\/8\/rjac388\/45623612\/rjac388.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2022\/8\/rjac388\/45623612\/rjac388.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T22:38:30Z","timestamp":1661899110000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjac388\/6678955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,1]]},"references-count":11,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjac388","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8]]},"published":{"date-parts":[[2022,8,1]]},"article-number":"rjac388"}}