Peritonectomy for disseminated peritoneal implantation after dermoid cyst spillage causing recurrent peritonitis and xanthogranulomatous reaction: a case report.

Abstract

Dermoid ovarian cysts, or mature cystic teratomas, are common benign ovarian masses. Surgical intervention for symptomatic cysts includes minimally invasive or open cystectomy. The consequences of intra-abdominal spillage during cystectomy can be significant and include acute chemical peritonitis or chronic granulomatous inflammatory reactions. This is the first reported case of peritonectomy for disseminated dermoid disease. This case report discusses a previously healthy 20-year-old patient who developed both these complications following elective laparoscopic ovarian cystectomy for dermoid ovarian cysts. She required multiple admissions and a multi-disciplinary approach to develop a treatment plan, culminating in peritonectomy. This case necessitated significant multi-disciplinary discussion to address complex treatment decisions regarding anti-microbial and surgical management. This is the first reported case of peritonectomy for source control of chronic sepsis and granulomatous peritonitis following disseminated dermoid disease, highlighting the importance of timely intervention and thorough peritoneal wash-out to mitigate late inflammatory complications.