Pyometra with Mural Air on the Uterine Wall: a case report

Reprint requests to: Dr. Jiun-Kai Fan Department of Radiology, Hsinchu Cathay General Hospital. No. 678, Sec. 2, Jung Hua Road, Hsinchu, 300, Taiwan, R.O.C. Pyometra refers to pus accumulation in the uterine cavity, which is usually seen in older women. Because most sufferers present nonspecific symptoms, a correct diagnosis is usually not made until operation for a ruptured pyometra. Pyometra is seen as a f luid-distended uterus on computed tomography (CT). This report presents a case of pyometra with a unique appearance on computed tomography. It appears as mural air on the uterine wall, similar to that seen in emphysematous cystitis. Pyometra, a condition of pus accumulation in the uterine cavity, is an uncommon gynecologic problem, which is mainly seen in postmenopausal women [1]. Pat ient s w ith pyomet ra may have vaginal discharge or vaginal bleeding indicating a gynecologic problem. Others may have only non-specific symptoms, such as abdominal pain or fever of unknown origin [1]. For those cases with non-specif ic symptoms, abdominal radiography and computed tomography (CT) a re the usual imaging studies of choice. Reported here is a case of pyometra with mural air on the uterine wall as seen on a CT. The case is similar to mural air on the bladder in emphysematous cystitis. Such an image has not previously been reported in human pyometra.