Spontaneous uterine perforation in post menopausal patient ? A case report

A 64 years postmenopausal woman approached emergency department due to acute abdominal pain and vomiting. Gynecological history of mild postmenopausal bleeding and increased vaginal discharge was noted since 10 days. Per abdomen was very tender distended, muscle rigidity. Emergency Explorative laparotomy was performed under the diagnosis of perforation of gastrointestinal (GI) tract. The uterus was found to have posterior wall perforation of 2x1 cm dimension and purulent material exuding from the uterine cavity was identified. Thus was diagnosed as perforated uterus due to pyometra. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was done uneventful. Patient recovered completely without any complications and was discharged. Perforation of uterus due to pyometra can cause the peritonitis in postmenopausal females with signs of acute abdomen as an unusual but serious condition.