Hunkler Kiley, Boedeker David, Casablanca Yovanni, Hill Micah
Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Reproductive Endocrinology and Infertility, National Institutes of Health, National Institute of Child Health and Human Development, Bethesda, MD, USA.
Case Rep Womens Health. 2024 Oct 30;44:e00660. doi: 10.1016/j.crwh.2024.e00660. eCollection 2024 Dec.
Pyometra is rare and refers to purulent material in the uterine cavity, which can lead to uterine perforation. A hysterectomy is the historic treatment for perforated pyometra due to the condition's high morbidity and mortality. A 33-year-old woman with uterine factor infertility underwent an abdominal myomectomy that was complicated by post-operative, perforated pyometra. She received conservative treatment with surgical debridement and broad-spectrum antibiotics. Following her recovery and subsequent infertility treatments, she had a term live birth through fertilization. The case highlights the value of uterine-sparing treatment in carefully selected patients with post-operative, perforated pyometra, in order to preserve fertility.
子宫积脓较为罕见,指的是子宫腔内的脓性物质,这可能导致子宫穿孔。由于该病症的高发病率和高死亡率,子宫切除术一直是治疗穿孔性子宫积脓的传统方法。一名33岁因子宫因素导致不孕的女性接受了腹部肌瘤切除术,术后并发穿孔性子宫积脓。她接受了手术清创和广谱抗生素的保守治疗。康复并随后接受不孕治疗后,她通过体外受精足月顺产。该病例凸显了在精心挑选的术后穿孔性子宫积脓患者中采用保留子宫治疗以保留生育能力的价值。