Pyomyoma after abortion: Uterus conserving surgery is possible to maintain fertility. Case report

Highlights

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  If initial treatment of endometritis is unsuccessful consider a differential diagnosis of a pyomyoma.

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  We can maintain patient’s fertility with a myomectomy and future pregnancy can be possible.

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  The post abortion period is a risk factor for pyomyoma even in cases of spontaneous miscarriage.

Abstract

Introduction

Pyomyoma is a rare complication associated with high rates of morbidity and mortality.

Presentation of case

We report the case of a 28-year-old nulligravida patient presenting pyomyoma following a spontaneous abortion at fourteen weeks and four days. Fourteen days following spontaneous miscarriage she was referred to the hospital with abdominal pain and fever. An antibiotic treatment was initiated. However, after ten days, the patient’s condition deteriorated and a decision for an emergency laparotomy made. The pyomyoma was successfully resected and the patient’s postoperative recovery was uneventful. A new pregnancy was confirmed two years later.

Discussion

The diagnosis of pyomyoma can be difficult but surgical treatment is often indicated. Performing a prompt myomectomy avoids the need for hysterectomy, preserving future fertility.

Conclusion

Pregnancy is possible following uterine sparing treatment of pyomyoma.