{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:02:49Z","timestamp":1771351369673,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ruptured pyometra is a rare but life-threatening condition that often presents with generalized peritonitis and septic shock, particularly in elderly patients. Although total hysterectomy with peritoneal lavage has traditionally been the standard treatment, it may impose excessive physiological stress in patients with poor general condition. We report a case of an elderly woman with ruptured pyometra who was treated with laparoscopic uterine-preserving management using open drainage. Intraoperatively, uterine perforations with purulent discharge were identified. Instead of closing the perforation, the uterine wall was intentionally incised to widely open the abscess cavity, allowing thorough irrigation of the uterine cavity and sustained drainage. This approach prioritized effective source control over anatomical repair. The postoperative course was favorable, and recurrent infection was successfully managed with additional minimally invasive drainage. This case suggests that laparoscopic open drainage without closure of uterine perforation may be a viable, life-saving option in selected high-risk patients.<\/jats:p>","DOI":"10.1093\/jscr\/rjag076","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:44:56Z","timestamp":1769604296000},"source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic uterine-preserving management of ruptured pyometra using open drainage: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Yuki","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0030-8078","authenticated-orcid":false,"given":"Hiroshi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Yamaoka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masumi","family":"Kiyose","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumiko","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumika","family":"Hamaguchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seigo","family":"Ibuchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Takemura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Takaishi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satomi","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanako","family":"Kawaharamura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nao","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyo","family":"Kakui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center , 2-17-77 Higashinaniwa Amagasaki Hyogo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"2026021712054205800_ref1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1159\/000349981","article-title":"Spontaneous perforation of pyometra: a report of seven cases and review of the literature","volume":"75","author":"Ikeda","year":"2013","journal-title":"Gynecol Obstet Invest"},{"key":"2026021712054205800_ref2","doi-asserted-by":"crossref","first-page":"60276","DOI":"10.1155\/IDOG\/2006\/60276","article-title":"Spontaneous uterine perforation due to pyometra presenting as acute abdomen","volume":"2006","author":"Geranpayeh","year":"2006","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2026021712054205800_ref3","doi-asserted-by":"publisher","first-page":"e657","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":"2026021712054205800_ref4","doi-asserted-by":"crossref","first-page":"rjac388","DOI":"10.1093\/jscr\/rjac388","article-title":"Spontaneous perforation of pyometra\u2014is hysterectomy required in the emergent setting? A case report and literature review","volume":"2022","author":"Browne","year":"2022","journal-title":"J Surg Case Rep"},{"key":"2026021712054205800_ref5","doi-asserted-by":"publisher","first-page":"761.e3","DOI":"10.1016\/j.ajem.2015.08.029","article-title":"Spontaneous perforation of pyometra presenting as acute abdomen: a case report and review of literature","volume":"34","author":"Yin","year":"2016","journal-title":"Am J Emerg Med"},{"key":"2026021712054205800_ref8","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/BF02482791","article-title":"Spontaneous perforation of pyometra with diffuse peritonitis: a case report","volume":"29","author":"Inui","year":"1999","journal-title":"Surg Today"},{"key":"2026021712054205800_ref9","first-page":"8887498","article-title":"Spontaneous perforation of pyometra diagnosed by contrast-enhanced computed tomography","volume":"2020","author":"Takamatsu","year":"2020","journal-title":"Case Rep Med"},{"key":"2026021712054205800_ref11","first-page":"83","article-title":"Pyometra in elderly postmenopausal women: a sign of malignancy","volume":"26","author":"Chan","year":"2005","journal-title":"Eur J Gynaecol Oncol"},{"key":"2026021712054205800_ref12","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4235\/jkgs.2016.20.1.42","article-title":"Pyometra in elderly patients and its clinical characteristics","volume":"20","author":"Cho","year":"2016","journal-title":"J Korean Geriatr Soc"},{"key":"2026021712054205800_ref13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.31083\/j.ceog5006130","article-title":"Clinical characteristics of pyometra: eleven years of experience from a single institution","volume":"50","author":"Ouh","year":"2023","journal-title":"Clin Exp Obstet Gynecol"},{"key":"2026021712054205800_ref14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.14740\/jcgo830","article-title":"Pyometrium as an early indicator of cervical squamous cell carcinoma: a systematic review","volume":"11","author":"Derynda","year":"2022","journal-title":"J Clin Gynecol Obstet"},{"key":"2026021712054205800_ref15","doi-asserted-by":"crossref","first-page":"168","DOI":"10.36129\/jog.2023.121","article-title":"The dual danger of pyometra and endometrial carcinoma: a case report","volume":"36","author":"Febriany","year":"2024","journal-title":"Ital J Gynaecol Obstet"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/2\/rjag076\/66963380\/rjag076.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/2\/rjag076\/66963380\/rjag076.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T17:05:50Z","timestamp":1771347950000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag076\/8488896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,31]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,1,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag076","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,31]]},"article-number":"rjag076"}}