EJMCR. 2020; 4(5): 173-176

Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature

Authors: Om Kumari, Amrita Gaurav, Meenakshi Manoj Kumar, Anshu Gupta, Jaya Chaturwedi, Kavita khoiwal.

ABSTRACT

Background: Suppurative leiomyoma (pyomyoma) is a rare complication of myoma. Pregnancy predisposes myoma for the acquisition of pyogenic infection. The expectant management of myoma is preferred during pregnancy, but pyomyoma mostly necessitates early surgical intervention to improve the maternal and fetal outcomes. A delayed diagnosis may result in lifethreatening complications. Case Presentation: We report a case of a 30-year-old female, second gravida presented to the emergency room at 33 weeksĺ gestation with 10 days of abdominal pain, fever, and vomiting. Abdominal examination showed distended tensed uterus with fundal height corresponding to 36 weeksĺ size Pyomyoma, which manifested as obstructive uropathy with acute kidney injury and managed successfully. The renal function test had a marked derangement with blood urea nitrogen being 76 mg/dl and serum creatinine of 2.6 mg/dl, with normal electrolytic values. Magnetic resonance imaging pelvis revealed an abdominopelvic mass of approximately 18 Î 11 cm with peripheral T1 hyperintensity and diffusion restriction and bilateral hydroureteronephrosis with extension. Laparotomy showed an irregular ragged mass of approximately 16 Î 10 cm extending from the posterior surface of the uterus to the right side broad ligament. It had friable degenerated tissues with purulent collection within it which was spontaneously draining suggestive of ruptured pyomyoma. Pyomyoma was enucleated, and the patient recovered well postoperatively. Conclusion: Pyomyoma should be strongly suspected in the cases of myoma with sepsis during pregnancy.

Keywords:
Pyomyoma, sepsis, acute kidney injury, case report


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Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature


Authors
Om Kumari
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
PubMed articlesGoogle scholar articles

Amrita Gaurav
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
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Meenakshi Manoj Kumar
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
PubMed articlesGoogle scholar articles

Anshu Gupta
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
PubMed articlesGoogle scholar articles

Jaya Chaturwedi
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
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Kavita khoiwal
Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India
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Correspondence to:
. Amrita Gaurav, Department of Obstetrics and Gynecology, AIIMS, Rishikesh, India.; AAMRITY@GMAIL.COM

Publication history
Received 15 Apr 2020
Accepted 18 May 2020
Published online 11 Jun 2020
Published in print 16 Jun 2020

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Pubmed Style

Kumari O, Gaurav A, Kumar MM, Gupta A, Chaturwedi J, khoiwal K. Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. EJMCR. 2020; 4(5): 173-176. doi:10.24911/ejmcr/173-1586942096


Web Style

Kumari O, Gaurav A, Kumar MM, Gupta A, Chaturwedi J, khoiwal K. Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. https://www.ejmcr.com/?mno=99461 [Access: July 11, 2020]. doi:10.24911/ejmcr/173-1586942096


AMA (American Medical Association) Style

Kumari O, Gaurav A, Kumar MM, Gupta A, Chaturwedi J, khoiwal K. Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. EJMCR. 2020; 4(5): 173-176. doi:10.24911/ejmcr/173-1586942096


Vancouver/ICMJE Style

Kumari O, Gaurav A, Kumar MM, Gupta A, Chaturwedi J, khoiwal K. Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. EJMCR. (2020), [cited July 11, 2020]; 4(5): 173-176. doi:10.24911/ejmcr/173-1586942096


Harvard Style

Kumari, O., Gaurav, . A., Kumar, . M. M., Gupta, . A., Chaturwedi, . J. & khoiwal, . K. (2020) Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. EJMCR, 4 (5), 173-176. doi:10.24911/ejmcr/173-1586942096


Turabian Style

Kumari, Om, Amrita Gaurav, Meenakshi Manoj Kumar, Anshu Gupta, Jaya Chaturwedi, and Kavita khoiwal. 2020. Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. European Journal of Medical Case Reports, 4 (5), 173-176. doi:10.24911/ejmcr/173-1586942096


Chicago Style

Kumari, Om, Amrita Gaurav, Meenakshi Manoj Kumar, Anshu Gupta, Jaya Chaturwedi, and Kavita khoiwal. "Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature." European Journal of Medical Case Reports 4 (2020), 173-176. doi:10.24911/ejmcr/173-1586942096


MLA (The Modern Language Association) Style

Kumari, Om, Amrita Gaurav, Meenakshi Manoj Kumar, Anshu Gupta, Jaya Chaturwedi, and Kavita khoiwal. "Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature." European Journal of Medical Case Reports 4.5 (2020), 173-176. Print. doi:10.24911/ejmcr/173-1586942096


APA (American Psychological Association) Style

Kumari, O., Gaurav, . A., Kumar, . M. M., Gupta, . A., Chaturwedi, . J. & khoiwal, . K. (2020) Pyomyoma presenting with obstructive uropathy and acute kidney injury in pregnancyŚcase report and review of literature. European Journal of Medical Case Reports, 4 (5), 173-176. doi:10.24911/ejmcr/173-1586942096


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