Essay On Pyometra

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Pyometra is defined as the collection of pus in the uterine cavity. The main cause of pyometra is cervical canal occlusion usually secondary to carcinoma cervix; however, other benign causes are endometrial polyp, leiomyoma, infection especially senile cervicitis, a forgotten intrauterine device, cervical occlusion after surgery, and radiation . The usual presentation of pyometra is a whitish discharge per vaginum. Sometimes the patients may present with the clinical triad of abdominal pain, purulent vaginal discharge, and postmenopausal bleeding. Nearly more than 50% of nonperforated pyometra patients are asymptomatic [4]. The most frequent preoperative diagnosis are generalized peritonitis, pneumoperitoneum and perforated gastrointestinal (GI) tract [5]. Spontaneously perforated pyometra is difficult to diagnose preoperatively. Clinically it commonly mimics the symptoms of gastrointestinal tract diseases. It is mentioned in prior case reports that, in most cases, a correct and definite diagnosis of spontaneous rupture pyometra was made only by exploratory laparotomy[6]. Abdominal USG has high sensitivity in assessing pyometra, but it plays a limited role in the diagnosis of perforated pyometra because of its inability to demonstrate the uterine breach and the limited sonographic window available due to pneumoperitoneum . However, this limitation can be overcome by TVS for detecting uterine defect and using dynamic TVS for demonstrating the real time movement of the endometrial collection through the defect into peritoneal

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