A silent breach, a collapsing bowel: deadly convergence of uterine perforation and gut ischemia

Rucha Bendale; Pranita Bankar; Kausha Shah

doi:10.18203/2320-1770.ijrcog20261650

Authors

Rucha Bendale Department of Obstetrics and Gynecology, BDBA Hospital, Mumbai, Maharashtra, India
Pranita Bankar Department of Obstetrics and Gynecology, BDBA Hospital, Mumbai, Maharashtra, India
Kausha Shah Department of Obstetrics and Gynecology, BDBA Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261650

Keywords:

Perforation, Uterus, Exploratory laparotomy, Emergency, Rheumatoid arthritis, Vasculitis

Abstract

An unusual presentation of postmenopausal women presenting as acute abdominal case with obstipation for 1 day with picture of sepsis. On further evaluation X Ray abdomen indicated air under diaphragm and provisional diagnosis of intestinal perforation was made. Patient underwent exploratory laparotomy for the same and intraoperatively it turned out to be relatively uncommon a case of non-traumatic spontaneous uterine perforation in a non-gravid uterus along with small bowel gangrene. This report highlights the diagnostic challenges and management considerations.

References

Browne IL. Spontaneous perforation of pyometra—is hysterectomy required in the emergent setting? A case report and literature review. J Surg Case Rep. 2022;2022:rjac388.

Yildizhan B, Uyar E, Sişmanoğlu A, Güllüoğlu G, Kavak ZN. Spontaneous perforation of pyometra. Infect Dis Obstet Gynecol. 2006;2006:26786.

İşlek Seçen E, Ağış H, Altunkaya C, Avşar AF. Postmenopausal spontaneous uterine perforation: a case report. Turk J Obstet Gynecol. 2015;12(2):122-4.

Nuamah NM, Hamaloglu E, Konan A. Spontaneous uterine perforation due to pyometra presenting as acute abdomen. Int J Gynecol Obstet. 2006;92(2):145-7.

Kitai T, Okuno K, Ugaki H, Komoto Y, Fujimi S, Takemura M. Spontaneous uterine perforation of pyometra presenting as acute abdomen. Case Rep Obstet Gynecol. 2014;2014:738568.

Yousefi Z, Sharifi N, Morshedy M. Spontaneous uterine perforation caused by pyometra: a case report. Iran Red Crescent Med J. 2014;16(11):e14491.

Gupta N, Rawat S, Verma N, Parineeta, Kumar R. Spontaneous uterine perforation presenting as acute abdomen: a diagnostic challenge. Int Surg J. 2023;10(4):1099-102.

McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365:2205-19.

Mongan ES, Cass RM, Jacox RF, Vaughen JH. A study of the relation of seronegative and seropositive rheumatoid arthritis to each other and to necrotizing vasculitis. Am J Med. 1969;47:23-35.

Sayah A, English JC. Rheumatoid arthritis: a review of the cutaneous manifestations. J Am Acad Dermatol. 2005;53:191-209.

Genta MS, Genta RM, Gabay C. Systemic rheumatoid vasculitis: a review. Semin Arthritis Rheum. 2006;36:88-98.

Taha ZI, Abdalla YA, Hamza SB, Eltagalawi MF, Abubakr ME, William J, et al. Rheumatoid vasculitis, an uncommon complication of non-deforming rheumatoid arthritis: a case report. Open Access Rheumatol. 2022;14:141-6.

Radic M, Martinovic Kaliterna D, Radic J. Overview of vasculitis and vasculopathy in rheumatoid arthritis—something to think about. Clin Rheumatol. 2013;32:937-42.

Schneider A, Merikhi A, Frank BB. Autoimmune disorders: gastrointestinal manifestations and endoscopic findings. Gastrointest Endosc Clin N Am. 2006;16(1):133-51.

Halabi H, AlDabbagh A, Alamoudi A. Gastrointestinal manifestations of rheumatic diseases. Skills in Rheumatology. Singapore: Springer. 2021.