{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:01:54Z","timestamp":1760148114084,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Pyometra is a uterine infection that causes pus to accumulate in the uterine cavity. Pyometra primarily affects postmenopausal women. Multiple aetiologies, including cervical stenosis, have been identified. Medical therapy using intravenous antibiotics and surgical evacuation are the conventional treatment options for pyometra. Here, we present a unique case of a novel therapy for pyometra in a geriatric patient; percutaneous alleviation of the causative cervical stenosis was performed using balloon dilatation, along with endometrial drainage of the infected fluid through her vagina, a natural route. This technique has overcome the need for other invasive therapies. The patient\u2019s clinical condition improved significantly after this minimally invasive treatment. Percutaneous balloon dilatation of the cervix for stenosis or occlusion in patients with pyometra facilitates drainage of the infected endometrial fluid. This alternative management technique ensured a satisfactory postoperative course and tolerance in the short-term follow-up. Furthermore, the technique ensured good aesthetic results, with its minimally invasive approach in selected patients, compared to other means of evacuation.<\/jats:p>","DOI":"10.3390\/medicina59040689","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T02:30:20Z","timestamp":1680229820000},"page":"689","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Pyometra Using a Novel Image-Guided Percutaneous Technique: A Case Report"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6590-5850","authenticated-orcid":false,"given":"Abdulaziz Mohammad","family":"Al-Sharydah","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar P.O. Box: 4398 (31952), Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz Abdullah","family":"AlMulhim","sequence":"additional","affiliation":[{"name":"Medical Imaging Department, Ministry of Health, Alahsa Health Cluster, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim Abdulhakim","family":"Al Shikmubarak","sequence":"additional","affiliation":[{"name":"King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulmohsen Ahmed","family":"Alhussaini","sequence":"additional","affiliation":[{"name":"Vascular Interventional Radiology, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghad Sulaiman","family":"Alehaideb","sequence":"additional","affiliation":[{"name":"Vascular Interventional Radiology, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Refaat","family":"Salman","sequence":"additional","affiliation":[{"name":"Vascular Interventional Radiology, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11564, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s00404-018-4997-9","article-title":"The incidence and predictors of gynecologic malignancies among postmenopausal patients with endometrial fluid collection","volume":"299","author":"Li","year":"2019","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1007\/s00330-005-2814-x","article-title":"Pathologies of the uterine endometrial cavity: Usual and unusual manifestations and pitfalls on magnetic resonance imaging","volume":"15","author":"Takeuchi","year":"2005","journal-title":"Eur. Radiol."},{"key":"ref_3","first-page":"952","article-title":"Pyometra. What is its clinical significance?","volume":"46","author":"Chan","year":"2001","journal-title":"J. Reprod. Med."},{"key":"ref_4","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":"ref_5","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":"ref_6","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":"ref_7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1479-828X.1995.tb01840.x","article-title":"Occasional Review: Spontaneous Uterine Perforation as a Serious Complication of Pyometra in Elderly Females","volume":"35","author":"Sawabe","year":"1995","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e931167-1","DOI":"10.12659\/AJCR.931167","article-title":"Postoperative Streptococcus constellatus bacteremia in a 75-year-old patient with pyometra: A case report","volume":"22","author":"Sala","year":"2021","journal-title":"Am. J. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e13659","DOI":"10.1097\/MD.0000000000013659","article-title":"Postmenopausal spontaneous rupture of pyometra: A case report","volume":"97","author":"Huang","year":"2018","journal-title":"Medicine"},{"key":"ref_10","first-page":"1605","article-title":"Spontaneous perforation of uterus presenting with pneumoperitoneum","volume":"10","author":"Hashmi","year":"2023","journal-title":"Eur. J. Mol. Clin. Med."},{"key":"ref_11","first-page":"738","article-title":"Postmenopausal endometrial fluid collections revisited: Look at the doughnut rather than the hole","volume":"83","author":"Goldstein","year":"1994","journal-title":"Obstet. Gynecol."},{"key":"ref_12","first-page":"542","article-title":"Treatment with ultrasound-guided percutaneous drainage of complicated post-cesarean vesicouterine hematomas. Experience in 4 cases","volume":"88","year":"2020","journal-title":"Ginecol. Y Obstet. De M\u00e9xico"},{"key":"ref_13","first-page":"e17","article-title":"Management of fluid accumulation within the endometrial cavity during a frozen embryo transfer cycle","volume":"109","author":"Chang","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1016\/S1074-3804(96)80323-9","article-title":"Fluoroscopically guided cervical dilatation in patients with infertility","volume":"3","author":"Zreik","year":"1996","journal-title":"J. Am. Assoc. Gynecol. Laparosc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1148\/radiology.200.2.8685347","article-title":"Transvaginal uterine cervical dilation with fluoroscopic guidance: Preliminary results in patients with infertility","volume":"200","author":"Dickey","year":"1996","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/OGX.0000000000000614","article-title":"Overcoming the challenging cervix: Identification and techniques to access the uterine cavity","volume":"73","author":"Wood","year":"2018","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"487","DOI":"10.11622\/smedj.2019113","article-title":"Clinics in diagnostic imaging (199)","volume":"60","author":"Tay","year":"2019","journal-title":"Singap. Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sherid, M., Samo, S., Sulaiman, S., Husein, H., Sifuentes, H., and Sridhar, S. (2016). Liver abscess and bacteremia caused by Lactobacillus: Role of probiotics? Case report and review of the literature. BMC Gastroenterol., 16.","DOI":"10.1186\/s12876-016-0552-y"},{"key":"ref_19","first-page":"e32016","article-title":"A Case of Pyometra Caused by Achromobacter xylosoxidans and \u03b3-Streptococcus in an Elderly Frail Woman","volume":"14","author":"Mukai","year":"2022","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1007\/s00261-016-0882-9","article-title":"Percutaneous image-guided pelvic procedures in women with gynecologic cancers: Utilization, complications, and impact on patient management","volume":"41","author":"Zahedi","year":"2016","journal-title":"Abdom. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","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."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/689\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:07:54Z","timestamp":1760123274000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/689"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040689"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040689","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2023,3,31]]}}}