Li C.-H.WEN-CHUN CHANG2021-02-032021-02-0320081344-6304https://www.scopus.com/inward/record.uri?eid=2-s2.0-58149402449&partnerID=40&md5=cfd9101c63dd47f23ed664f4ab388e7bhttps://scholars.lib.ntu.edu.tw/handle/123456789/546087Spontaneous perforation of the uterus is rare and only several cases have been reported in the English medical literature. Most of the patients had gynecological malignancy and almost all were associated with cervical occlusion. We report a case of diffuse peritonitis resulting from spontaneously perforated pyometia with an intrauterine device (IUD) inserted for more than two decades. This case differs from others in that the cervical canal was not occluded. In the absence of other possible causes of uterine perforation, the etiology in this case is mostly likely hemorrhagic necrosis related to the long-term IUD.[SDGs]SDG3C reactive protein; fluconazole; imipenem; metronidazole; RNA 16S; abdominal distension; abdominal pain; aged; anorexia; article; bacterial growth; bacterium culture; bacterium isolation; Bacteroides fragilis; case report; computer assisted tomography; creatinine blood level; female; fever; gene sequence; gynecologic disease; hemodialysis; hospital discharge; human; intrauterine contraceptive device; kidney function; laparotomy; leukocyte count; leukocytosis; liver function test; menopause; palpation; peritonitis; physical examination; pyometra; salpingooophorectomy; septic shock; vagina discharge; vaginal hysterectomy; vomiting; intrauterine contraceptive device; menopause; peritonitis; pyometra; uterus perforation; Aged; Female; Humans; Intrauterine Devices; Menopause; Peritonitis; Pyometra; Uterine Perforationjournal article190503592-s2.0-58149402449