Protracted Chemical Peritonitis Following Laparoscopy for Dermoid Cyst: A management dilemma

TL;DR

A patient developed rare chemical peritonitis after laparoscopic surgery for an ovarian dermoid cyst, requiring complex and prolonged treatment.

Contribution

This case highlights the management challenges of a rare complication following laparoscopic surgery for dermoid cyst torsion.

Findings

Chemical peritonitis occurred following laparoscopic salpingo-oophorectomy for a torsed dermoid cyst.

Management required prolonged hospitalization, antibiotics, anti-inflammatory therapy, and multiple surgical interventions.

This case underscores the limited guidelines for treating this rare post-surgical complication.

Abstract

Dermoid cysts are common benign ovarian tumours arising from totipotent germ cells. We report a rare case of chemical peritonitis and prolonged fever following laparoscopic salpingo-oophorectomy for torsion of a large ovarian dermoid and discuss the management of this patient with prolonged hospital stay, antibiotics and anti-inflammatory use, repeated drainage of the collection as well as re-laparotomy. The occurrence of this rare condition can be extremely distressing for the patient and treating surgeon alike, as the recommendations for management are limited. The management of chemical peritonitis may require one or more surgical procedures along with prolonged anti-inflammatory therapy.

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