子宮蓄膿併發穿孔引起氣腹：病例報告

Pneumoperitoneum Caused by Perforation of a Pyometra: A Case Report

王俊順(Chun-Shun Wang) ； 王賡堯(Gern-Yao Wang) ； 謝從閭(Tsorng-Liu Hsieh) ； 程惠民(Huei-Ming Cheng)

《中華民國急救加護醫學會雜誌》 8卷2期 (1997/06) Pp. 89-92

https://doi.org/10.30018/JECCM.199706.0005

摘要

八十一歲女性糖尿病息者，因發燒，小便疼痛，腰痛，血糖偏高，于本院急診診斷爲急性腎盂腎炎合幷敗血症。住院第二天理學檢查發現廣泛性腹部壓痛及明顯反彈性疼痛，胸部X光檢查顯示有氣腹情形，在消化性潰瘍穿孔合幷休克的臆斷下，施行緊急的剖腹探查，術中未見任何中空器官之破裂，却發現腹腔、骨盆腔內積膿及子宮底部破裂情形，診斷爲子宮蓄膿合幷穿孔。老年婦人急性腹痛，婦科問題應列入鑑別診斷，以增加手術前正確的診斷。

關鍵字

子宮蓄膿 ； 子宮穿孔 ； 氣腹

並列摘要

An 81-year-old female presented with symptoms of fever, dysuria, back pain, and hyperglycemia. After admission, she had an acute onset of diffuse abdominal pain with rebound tenderness. The CXR revealed pneumoperitoneum. Under the impression of a peptic ulcer perforation, an emergent exploratory laparotomy was performed. Instead a perforated pyometra was found.
Although uterine disease is a rare cause of an acute abdomen and pneumoperitoneum in the elderly, a perforated pyometra should be considered in the differential diagnosis.

並列關鍵字

pyometra ； perforation ； pneumoperitoneum