{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:55:43Z","timestamp":1780386943604,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Obstetrics and Gynecology"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p>Spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. Herein, we report the case of a 63-year-old woman who presented to emergency department with a 2-day history of severe diffuse abdominal pain, high-grade fever, nausea, and vomiting. Acute abdomen series was done, and upright plain chest radiograph showed free air under diaphragm. A noncontrast-enhanced computed tomography scan showed a significantly distended fluid-filled uterus measuring 10 \u00d7 7.8 \u00d7 10\u2009cm, in addition to a single focus of perforation involving the uterine fundus and associated with presence of free air within the nondependant area. No evidence of ascites or pelvi-abdominal lymphadenopathy was identified. A preoperative diagnosis of generalized peritonitis secondary to spontaneous perforation of uterus was established. Subsequently, patient underwent urgent exploratory laparotomy which revealed pus-filled uterus with perforated fundus. Diagnosis of generalized peritonitis secondary to spontaneous perforation of pyometra was established. Consequently, patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as thorough drainage and irrigation of pelvi-abdominal cavity. Postoperatively, patient was admitted to intensive care unit. Histopathological examination of uterus was negative for malignancy, and surgical culture grew<jats:italic>Streptococcus constellatus<\/jats:italic>. Patient had an uneventful recovery. Moreover, a brief literature review on pyometra is presented.<\/jats:p>","DOI":"10.1155\/2013\/929407","type":"journal-article","created":{"date-parts":[[2013,8,29]],"date-time":"2013-08-29T21:02:27Z","timestamp":1377810147000},"page":"1-4","source":"Crossref","is-referenced-by-count":7,"title":["Generalized Peritonitis Secondary to Spontaneous Perforation of Pyometra in a 63-Year-Old Patient"],"prefix":"10.1155","volume":"2013","author":[{"given":"Ahmed","family":"Abu-Zaid","sequence":"first","affiliation":[{"name":"College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"AlOmar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center (KFSH&RC), P.O. Box 3354, Riyadh 11211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Nazer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center (KFSH&RC), P.O. Box 3354, Riyadh 11211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Azzam","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Abudan","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Al-Badawi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center (KFSH&RC), P.O. Box 3354, Riyadh 11211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","volume":"2006","year":"2006","journal-title":"Infectious diseases in obstetrics and gynecology"},{"issue":"1","key":"2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1479-828X.1995.tb01840.x","volume":"35","year":"1995","journal-title":"Australian and New Zealand Journal of Obstetrics and Gynaecology"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(94)02241-0"},{"issue":"11","key":"4","first-page":"952","volume":"46","year":"2001","journal-title":"Journal of Reproductive Medicine for the Obstetrician and Gynecologist"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.04.012"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1993.1231"},{"issue":"4","key":"5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1159\/000291980","volume":"42","year":"1996","journal-title":"Gynecologic and Obstetric Investigation"},{"issue":"6","key":"8","doi-asserted-by":"crossref","first-page":"477","DOI":"10.7883\/yoken.JJID.2008.477","volume":"61","year":"2008","journal-title":"Japanese Journal of Infectious Diseases"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2010.01184.x"},{"issue":"6","key":"10","first-page":"294","volume":"74","year":"1985","journal-title":"Annales Chirurgiae et Gynaecologiae"},{"issue":"3","key":"11","first-page":"235","volume":"12","year":"2011","journal-title":"Journal of Reproduction and Infertility"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1155\/IDOG\/2006\/60276"},{"key":"13","doi-asserted-by":"crossref","first-page":"60","DOI":"10.4103\/2278-960X.104299","volume":"1","year":"2012","journal-title":"Journal of Basic and Clinical Reproductive Sciences"},{"issue":"2","key":"14","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5348\/ijcri-2012-02-89-CR-3","volume":"3","year":"2012","journal-title":"International Journal of Case Reports and Images"},{"issue":"5","key":"15","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/s005950050624","volume":"30","year":"2000","journal-title":"Surgery Today"},{"issue":"4","key":"16","first-page":"449","volume":"36","year":"1993","journal-title":"Journal of Family Practice"}],"updated-by":[{"DOI":"10.1155\/2014\/180867","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2014,1,9]],"date-time":"2014-01-09T00:00:00Z","timestamp":1389225600000}}],"container-title":["Case Reports in Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/criog\/2013\/929407.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criog\/2013\/929407.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criog\/2013\/929407.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T05:42:35Z","timestamp":1688449355000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/criog\/2013\/929407\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013]]},"references-count":16,"alternative-id":["929407","929407"],"URL":"https:\/\/doi.org\/10.1155\/2013\/929407","relation":{"erratum":[{"id-type":"doi","id":"10.1155\/2014\/180867","asserted-by":"object"}]},"ISSN":["2090-6684","2090-6692"],"issn-type":[{"value":"2090-6684","type":"print"},{"value":"2090-6692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013]]}}}