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CT of a Ruptured Pyomyoma

Musturay Karcaaltincaba1,2 and Gary S. Sudakoff3

1 Department of Radiology, Digital Imaging Section, Medical College of Wisconsin, Milwaukee, WI 53226.
2 Present address: Department of Radiology, Hacettepe University, Ankara 06100, Turkey.
3 Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, 9200 W Wisconsin Ave., Milwaukee, WI 53226.



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  		Fig. 1A. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Initial longitudinal sonogram of lower uterine segment (straight arrows) obtained during spontaneous abortion shows deformed fetal head (curved arrows) and lack of placenta and amniotic fluid.

 


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  		Fig. 1B. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Transverse sonogram obtained through uterine fundus at same time as A shows dominant right lateral uterine leiomyoma (arrows).

 


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  		Fig. 1C. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Transverse sonogram obtained 7 days after spontaneous abortion shows right lateral uterine mass with interval development of internal echoes and reverberation artifact (arrow), suggestive of pyomyoma.

 


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  		Fig. 1D. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Axial 5.0-mm-collimated CT scan of lower abdomen shows several uterine leiomyomas. Dominant right lateral leiomyoma contains internal gas and debris (arrows) and small amount of surrounding fluid. Wall of pyomyoma appears intact.

 


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  		Fig. 1E. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Coronal CT reformation shows enlarged uterus (U) with irregularity of superior wall of right lateral pyomyoma (arrow), suggesting focal disruption.

 


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  		Fig. 1F. —36-year-old woman who presented with acute abdomen 7 days after spontaneous abortion. Sagittal CT reformation obtained on right side through pyomyoma shows irregularity of superior wall (curved arrows) suggesting sites of focal disruption with surrounding intraperitoneal fluid and air (straight arrows).

 

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