LAUSR

An 87-year-old woman undergoing intermittent hemodialysis suffered from prolonged fever, leukocytosis, and an increase in C-reactive protein. The use of antibiotics was ineffective and she was referred to our hospital. Computed tomography revealed a pooling of fluid with gas within the uterus and a huge amount of stools with metallic density in the colon (Fig. 1). She was diagnosed as having pyometra due to severe constipation. Following the forced defecation by an enema, the pus flowed out from the endometrial cavity, and her conditions improved. Since then, pyometra has not recurred over a year by the control of defecation. Severe constipation is often seen in hemodialysis patients, because their water intake is restricted and because many of them are prescribed with medications possibly causing constipation, such as phosphate binders. Pyometra is a rare disease condition resulting from cervical occlusion [1].