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Minimally Invasive Approach to Benign Postmenopausal Pyometra and Spontaneous Uterine Rupture.

Danielle I, Sarah G, Laura R, Andreea N and Emily KH

Pyometra, the accumulation of pus in the uterus, is typically associated with cervical occlusion and malignancy. Rarely, pyometra progresses to spontaneous uterine rupture (SUR) and sepsis, which carries high morbidity and mortality. Definitive management is surgical, typically laparotomy and hysterectomy. We present a case of pyometra in a 65 year-old female. Despite cervical patency and absence of malignancy, her pyometra progressed to SUR and septic shock. She was successfully managed with a staged minimally invasive approach consisting of laparoscopic abdominal washout and drain placement followed by total laparoscopic hysterectomy. Though laparotomy has been the primary approach to pyometra complicated by spontaneous uterine rupture, a laparoscopic approach may be considered.