子宮留膿症穿孔による汎発性腹膜炎の5例  [in Japanese] FIVE CASES OF PERFORATED PYOMETRA PRESENTING WITH DIFFUSE PERITONITIS  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

子宮留膿症は,子宮内腔からの分泌物のドレナージが,何らかの機転で阻害されて,子宮内腔に膿瘍を形成する疾患で,比較的稀なる疾患である.更にそれが穿孔して腹膜炎をおこすのは非常に珍しいと言われている.われわれは1985年から1993年までに,5例の子宮留膿症穿孔による腹膜炎を経験した.全例明らかなる前駆症状がなく,突然のはげしい腹痛で発症した. CT, US等を施行したが術前診断可能なものは2例のみであった.全例,緊急手術を行い,子宮単純摘出術術附属器摘出術を行った.5例中1例は,術前よりのショックが術後も改善されず死亡した.組織学的に悪性を示すものはなかった.高齢化社会を迎えてこの疾患が少しずっ増して来ると思われるので,原因不明のはげしい腹痛を有する高齢者婦人の診断にあたっては,子宮留膿症穿孔による汎発性腹膜炎を念頭に入れて, CT, US等による慎重なる検索が必要と思われる.

Pyometra is a relatively rare disease to form an abscess in the uterus when drainage of discharge from the uterus is inhibited at somewhere. Besides, perforated pyometra causing peritonitis is very uncommon. From 1985 to 1993, emergency operation was undertaken for 5 cases of perforated pyometra presenting with diffuse peritonitis. They were all more than 70 years old.<br> Severe anbdominal pain occurred suddenly in all cases and one case fell in profound shock status soon after that symptom.<br> Diagnosis was tried to make using CT, ultrasonography and simple abdominal X-ray examination, but only 2 cases were detected as the perforated pyometra by those diagnostic aids.<br> Histerectomy with bilateral salpingoopharectomy was carried out in cases.<br> Histological examination revealed pyometra with inflammation and destruction of the endmetrium and myometorium without any evidence of malignancy.<br> Postoperative course was uneventful in 4 cases. However, one case could not recover from profound shock status and died of sepsis.<br> This disease will increasingly appear from now on when we are seeing the aged society. Any typical symptoms could not be detected before perforation of pyometra, accordingly rigorous and careful examinations are necessary for aged female patient complaining of severe abdominal pain of unknown origin.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 56(9), 1955-1958, 1995-09-25

    Japan Surgical Association

References:  5

Cited by:  4

Keywords

Codes

  • NII Article ID (NAID)
    10008515792
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
Page Top