Chemical peritonitis after iatrogenic rupture of an ovarian dermoid cyst during laparoscopy - Case report 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. I t is a rare but a potentially dangerous issue. Its treatment may need one o r more reoperations. We report here the case of a patient operated on in em ergency for a torsion of an ovarian dermoid cyst, with peritoneal spillage of its content during coeliosurgery. The prolonged contact between the seba ceous material and the peritoneum has led to a chemical peritonitis. Two mo re laparoscopic interventions, associated with a systemic anti-inflammatory treatment, were necessary to relieve symptoms. We propose the following at titude to avoid this complication: (I)puncture and drainage of the cyst wit h a trocar; (2) extraction of the cyst in an endobag, and (3) abundant wash out of the peritoneal cavity.