Uncovering a peritoneal inclusion cyst after surgery: A case report

Abstract

Peritoneal inclusion cysts (PICs) are benign, multilocular fluid-filled lesions that predominantly affect women of reproductive age, often arising after abdominal surgery or chronic inflammation. We present the case of a 30-year-old woman with a history of laparotomy for a myometrial mass, who developed severe lower abdominal pain and distension 5 months postsurgery. Initial ultrasound revealed a large intraperitoneal fluid collection measuring 10 cm, with debris and septations. MRI further characterized the lesion as a peritoneal inclusion cyst, showing enhancing septations and no solid components. The patient underwent laparotomy for adhesion release and complete cyst excision, leading to complete symptom resolution. At 6-month follow-up, she remained asymptomatic with no evidence of recurrence. This case underscores the importance of considering PICs in the differential diagnosis of abdominal pain or cystic lesions in women with a history of abdominal surgery. Imaging, particularly ultrasound and MRI, plays a critical role in diagnosing PICs and distinguishing them from other conditions such as paraovarian cysts, hydrosalpinx, or ovarian malignancies. Treatment options range from conservative management to surgical intervention, depending on the patient's symptoms and clinical presentation. Early recognition and appropriate management of PICs can prevent complications and improve outcomes. This report highlights the diagnostic challenges and therapeutic approaches for PICs, emphasizing the need for a multidisciplinary approach in managing these lesions.