| Summary points: | A 69-year-old woman presents with abdominal pain, fever episode, vomiting, and anorexia for 1 day; for 2 weeks prior to admission, she had preceding purulent vaginal discharge. Physical examination, laboratory studies, computed tomography, and laparotomy are described. The authors discuss a case of diffuse peritonitis resulting form spontaneously perforated pyometra with an intrauterine device inserted for more than 20 years. |