Pyometra is the accumulation of pus in the uterine cavity. The reported incidence varies from 0.5% in young patients to 13.6% in elderly patients attending gynecological clinic. It is a common complication of malignancy of cervix and uterine body. The cause of pyometra is the occlusion of cervical canal by benign or malignant growth, stenosis following age‑related atrophy, radiation treatment, or surgery on the cervix. A spontaneous rupture of pyometra causing diffuse peritonitis is very rare, with reported incidence of 0.01% to 0.5% in elderly women. Unless recognized in time, it can be a life‑threatening condition. We present a case of 65‑year‑old woman who presented with this rare and life‑threatening complication. She was treated by emergency exploratory laparotomy. Total abdominal hysterectomy with bilateral salpingo ophorectomy was performed. Patient had uneventful postoperative period.
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