A Case of Pan-peritonitis due to Perforation of the Pyometra as a Result of Invasion of Rectal Cancer to the Uterus

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 38; no. 4; pp. 469 - 473
• Main Authors: Kawamoto, Masaki, Yasoshima, Takahiro, Sogahata, Katsuya, Matsumura, Nobuyuki, Sato, Takashi, Hirata, Koichi, Mizushima, Yasuhiro, Hata, Fumitake, Someya, Tetsufumi, Nomura, Hiroki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2005
• Subjects: pyometra; rectal cancer; rupture of uterus
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.38.469

We report a rare case of panperitonitis due to pyometral perforation due to rectal cancer invading the uterus. An 88-year-old woman with a high fever and appetite loss was diagnosed with panperitonitis due to appendix perforation, demonstrated by palpation, which showed diffuse muscle guarding, and abdominal computed to-mography (CT), which showed an abscess around the appendix. Emergency surgery showed perforation of the uterine fundus, which had been invaded by rectal cancer involving the left ovary, necessitating resection of the rectum, uterus, and left ovary. Pathologically, rectal cancer had metastasized to the uterus, where contamination uterine cavity contributed to pyometral perforation when progressing rectal cancer obstructed the uterus. The possibility of pyometral perforation should thus be considered in elderly women diagnosed with generalized peritonitis. The peritoneal cavity must also be thoroughly examined to rule out the rare inva-sion of malignant cancer.