{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:37:01Z","timestamp":1787841421206,"version":"build-2784847793"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>\n                    Spontaneous perforations in pyometra occur rarely. Incidence is only 0.01%\u20130.5% in gynecological patients. Tubo-ovarian abscess (TOA) is seen less in postmenopausal women amounting the 6%\u201318% of the total cases of TOA reported. A 52-year-old P\n                    <jats:sub>3<\/jats:sub>\n                    L\n                    <jats:sub>3<\/jats:sub>\n                    postmenopausal woman with abdominal pain was admitted to hospital. Emergency laparotomy was performed in view of pyoperitoneum. Intraoperatively, 1000 cc of foul-smelling pus was suctioned out from the peritoneal cavity a 2 cm \u00d7 2 cm sized perforation was seen at the right fundal region of the uterus and a right sided TOA was seen extending to the uterine cavity, left sided ovary was normal. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The patient got discharged on the 36\n                    <jats:sup>th<\/jats:sup>\n                    postoperative hospitalization day. Histopathological study revealed uterine purulent inflammation with no evidence of malignancy. The diagnosis of spontaneous perforation of pyometra is rarely made preoperatively and the possibility of a perforated pyometra should, therefore, be considered when elderly women suffer from acute abdominal pain. Hysterectomy and bilateral salpingo-oophorectomy may be the best choice procedure in these patients. There is probably a new trend in the epidemiology of TOA, occurring in older women who do not present the traditional risk factors for pelvic inflammatory disease and TOA.\n                  <\/jats:p>","DOI":"10.4103\/jmh.jmh_6_24","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T08:01:02Z","timestamp":1720166462000},"page":"112-114","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Postmenopausal Idiopathic Spontaneous Rupture of Pyometra with Tubo-ovarian Abscess: An Atypical Presentation"],"prefix":"10.4103","volume":"15","author":[{"given":"Nikita","family":"Krishna","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabha","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"R1-20240906","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":"R2-20240906","doi-asserted-by":"crossref","first-page":"101789","DOI":"10.1016\/j.jogoh.2020.101789","article-title":"Tubo-ovarian abscess in postmenopausal women:A systematic review","volume":"49","author":"Gil","year":"2020","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"R3-20240906","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ijgo.2005.09.027","article-title":"Spontaneous uterine perforation due to pyometra presenting as acute abdomen","volume":"92","author":"Nuamah","year":"2006","journal-title":"Int J Gynaecol Obstet"},{"key":"R4-20240906","first-page":"738568","article-title":"Spontaneous uterine perforation of pyometra presenting as acute abdomen","volume":"2014","author":"Kitai","year":"2014","journal-title":"Case Rep Obstet Gynecol"},{"key":"R5-20240906","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5348\/ijcri-2012-02-89-CR-3","article-title":"Perforated pyometra presenting as a pelvic abscess:A case report","volume":"3","author":"Khan","year":"2012","journal-title":"Int J Case Rep Imag"},{"key":"R6-20240906","doi-asserted-by":"crossref","first-page":"e231","DOI":"10.1016\/j.jemermed.2016.01.024","article-title":"A case report and literature review of spontaneous perforation of pyometra","volume":"50","author":"Uno","year":"2016","journal-title":"J Emerg Med"},{"key":"R7-20240906","first-page":"Doc09","article-title":"Idiopathic pyometra and tubo-ovarian abscess in a postmenopausal patient treated conservatively","volume":"20","author":"Ntioudi","year":"2022","journal-title":"Ger Med Sci"}],"container-title":["Journal of Mid-life Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_6_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:54:11Z","timestamp":1787838851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_6_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jmh.jmh_6_24","relation":{},"ISSN":["0976-7800","0976-7819"],"issn-type":[{"value":"0976-7800","type":"print"},{"value":"0976-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2024-01-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}