title: Laparoscopic management of chemical peritonitis caused by dermoid cyst spillage.
abstract: BACKGROUND
  Dermoid cyst is the most frequent benign ovarian tumor. Spillage of cyst contents during surgery is common and can rarely lead to chemical peritonitis.
  
  
  METHODS
  A patient presented 3 days after attempted laparoscopic removal of bilateral dermoid cysts.  On examination, she had a low-grade fever, rebound tenderness with guarding, and a markedly elevated white blood cell count. A decision was made to proceed with laparoscopy with the presumptive diagnosis of chemical peritonitis. Laparoscopic findings included residual dermoid cyst contents  and extensive filmy adhesions of the bowel and omentum to the peritoneal surface. The chemical peritonitis resolved after laparoscopic removal of residual dermoid cyst content including bilateral salpingo-oophorectomy and copious irrigation.
  
  
  CONCLUSIONS
  Early recognition and prompt  treatment by repeat laparoscopic surgery with removal of the remaining cyst contents and peritoneal lavage can be a successful method for treating chemical peritonitis.
authors: Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. alirezashamshirsaz@yahoo.com
authors: Alireza A
authors: AA
authors: Shamshirsaz
authors: Amirhoushang A
authors: AA
authors: Shamshirsaz
authors: Jill L
authors: JL
authors: Vibhakar
authors: Christina
authors: C
authors: Broadwell
authors: Bradley J
authors: BJ
authors: Van Voorhis
mesh_terms: D000328:Adult; D003884:Dermoid Cyst / Q000601:surgery*; D004210:Dissection; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D010535:Laparoscopy; D009852:Omentum / Q000601:surgery; D010048:Ovarian Cysts / Q000601:surgery*; D010052:Ovariectomy; D010533:Peritoneal Lavage; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*