[Chemical peritonitis after iatrogenic rupture of a dermoid cyst of the ovary treated by coelioscopy. Apropos of a case and review of the literature].
Dermoid cyst is the most frequent benign ovarian tumor. Its intraperitoneal rupture may lead to a peritoneal reaction known as chemical peritonitis. It is a rare but a potentially dangerous issue. Its treatment may need one or more reoperations. We report here the case of a patient operated on in emergency for a torsion of an ovarian dermoid cyst, with peritoneal spillage of its content during coeliosurgery. The prolonged contact between the sebaceous material and the peritoneum has led to a chemical peritonitis. Two more laparoscopic interventions, associated with a systemic anti-inflammatory treatment, were necessary to relieve symptoms. We propose the following attitude to avoid this complication: (1) puncture and drainage of the cyst with a trocar; (2) extraction of the cyst in an endobag, and (3) abundant washout of the peritoneal cavity.
Achtari
C
C
Département de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
Genolet
P M
PM
Bouzourene
H
H
De Grandi
P
P
D000328:Adult; D003884:Dermoid Cyst / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D010535:Laparoscopy; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010538:Peritonitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012421:Rupture; D014102:Torsion Abnormality / Q000601:surgery