Pyometrium

Last revised by Joshua Yap on 18 Oct 2022

Pyometrium refers to infection of the endometrial cavity with resulting expansion due to accumulated pus (pyometra).

The postmenopausal demographic are most commonly affected due to the association with uterine malignancy.

Pathology

Etiology

Radiographic features

Ultrasound
  • tenderness to uterine palpation

  • distended uterine cavity containing complex (echogenic) fluid

    • may contain gas bubbles or gas-fluid level

  • hyperemic endometrium

  • complex free fluid in the pouch of Douglas

CT
  • distended uterine cavity

  • complex endometrial fluid

    • may demonstrate gas-fluid level

  • inflammatory stranding in the parametrial fat

  • complex free fluid in the pouch of Douglas

  • hyperenhancing endometrium

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