Ovarian dermoid presenting as acute intestinal obstruction: a rare case report and review of literature

Bhasin, Sanjiv Kumar; Malik, Sayeed Majeed; Sharma, Gopal; Gupta, Shyam

doi:10.5455/2349-2902.isj20150533

Cited by 10 publications

(19 citation statements)

References 9 publications

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“…Most have a 46XX karyotype and by parthenogenesis develop from a single haploid germ cell. This theory supports the presence of Barr bodies (nuclear sex chromatin) in the tumour cells (8). There are no new data about the risk factors for the development of the benign dermoid cyst.…”

Section: Aetiologysupporting

confidence: 61%

“…The word teratoma is derived from Greek word teras, which means monster. This term was formulated in 1863 in the first edition of Virchow's book about tumours (8). Teratomas can be divided into two groups: a) mature teratomas, which include dermoid cysts, and are generally benign b) immature teratomas, which can be cancerous (9).…”

Section: Definitions and Classificationmentioning

confidence: 99%

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Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report

Bužinskienė¹,

Mongirdas²,

Mikėnas³

et al. 2020

AML

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Background. Mature cystic teratomas (dermoid cysts) are the most common germ cell tumours with 10–25% incidence of adult and 50% of paediatric ovarian tumours. The aetiology of dermoid cysts is still unclear, although currently the parthenogenic theory is most widely accepted. The tumour is slow-growing and in the majority of cases it is an accidental finding. Presenting symptoms are vague and nonspecific. The main complication of a dermoid cyst is cyst torsion (15%); other reported complications include malignant transformation (1–2%), infection (1%), and rupture (0.3–2%). Prolonged pressure during pregnancy, torsion with infarction, or a direct trauma are the main risk factors for a spontaneous dermoid rupture that can lead to acute or chronic peritonitis. The diagnosis of mature cystic teratoma is often made in retrospect after surgical resection of an ovarian cyst, because such imaging modalities as ultrasound, computer tomography, or magnetic resonance imaging cannot yet accurately and reliably distinguish between benign and malignant pathology. Materials and methods. We present a report of a clinical case of a 35-years-old female, who was referred to the hospital due to abdominal pain spreading to her feet for three successive days. She had a history of a normal vaginal delivery one month before. Abdominal examination revealed mild tenderness in the lower abdomen; no obvious muscle rigidity was noted. Transvaginal ultrasound showed a multiloculated cystic mass measuring 16 × 10 cm in the pelvis. In the absence of urgency, planned surgical treatment was recommended. The next day the patient was referred to the hospital again, with a complaint of stronger abdominal pain (7/10), nausea, and vomiting. This time abdominal examination revealed symptoms of acute peritonitis. The ultrasound scan differed from the previous one. This time, the transvaginal ultrasound scan revealed abnormally changed ovaries bilaterally. There was a large amount of free fluid in the abdominal cavity. The patient was operated on – left laparoscopic cystectomy and right adnexectomy were performed. Postoperative antibacterial treatment, infusion of fluids, painkillers, prophylaxis of the thromboembolism were administered. The patient was discharged from the hospital on the seventh postoperative day and was sent for outpatient observation. Results and conclusions. Ultrasound is the imaging modality of choice for a dermoid cyst because it is safe, non-invasive, and quick to perform. Leakage or spillage of dermoid cyst contents can cause chemical peritonitis, which is an aseptic inflammatory peritoneal reaction. Once a rupture of an ovarian cystic teratoma is diagnosed, immediate surgical intervention with prompt removal of the spontaneously ruptured ovarian cyst and thorough peritoneal lavage are required.

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Section: Aetiologysupporting

confidence: 61%

Section: Definitions and Classificationmentioning

confidence: 99%

Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report

Bužinskienė¹,

Mongirdas²,

Mikėnas³

et al. 2020

AML

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“…This case report has highlighted a rare case of emergency presentation with a spontaneously ruptured ovarian dermoid cyst complicated by generalised purulent peritonitis and small bowel obstruction. Dermoid ovarian cysts, or mature cystic teratomas, are mainly composed of multiple cell types derived from one or more of the three germ layers, and they range from benign, well-differentiated (mature) cystic lesions to those that are solid and malignant (immature) 2 4 7. They account for 10%–20% of all ovarian tumours and are the most common benign ovarian neoplasms found in adolescents and during pregnancy 2 4 7.…”

Section: Discussionmentioning

confidence: 99%

“…Dermoid ovarian cysts, or mature cystic teratomas, are mainly composed of multiple cell types derived from one or more of the three germ layers, and they range from benign, well-differentiated (mature) cystic lesions to those that are solid and malignant (immature) 2 4 7. They account for 10%–20% of all ovarian tumours and are the most common benign ovarian neoplasms found in adolescents and during pregnancy 2 4 7. Most dermoid ovarian cysts remain asymptomatic for a long time, yet, rarely, serious complications may occur 4 5 7.…”

Section: Discussionmentioning

confidence: 99%

“…Chemical peritonitis due to iatrogenic ovarian dermoid cyst rupture is a rare complication following surgery 1–3. Spontaneous rupture of a dermoid cyst is even rarer 4–6. We report a rare case of emergency presentation with a spontaneously ruptured ovarian dermoid cyst causing significant generalised purulent peritonitis and small bowel obstruction directly attributable to bowel adherence at the perforation site.…”

Section: Introductionmentioning

confidence: 93%

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Generalised purulent peritonitis and small bowel obstruction due to a spontaneously perforated ovarian dermoid cyst

Simillis¹,

Cribb

Gurtovaya

et al. 2019

BMJ Case Rep

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We outline the narrative of a 28-year-old woman who initially presented to the emergency department with vomiting, diarrhoea, abdominal pain and fever. Blood tests revealed significantly raised inflammatory markers and acute renal failure. Initially, this was attributed to gastroenteritis due to a recent foreign travel, but further investigations and radiological imaging revealed a large right ovarian dermoid cyst with a significant amount of free intra-abdominal fluid and small bowel dilation. She underwent laparotomy, which revealed a spontaneously perforated right ovarian dermoid cyst resulting in generalised purulent peritonitis and small bowel obstruction due to bowel adherence at the perforation site. Meticulous adhesiolysis, right salpingo-oophorectomy and extensive peritoneal lavage were performed, with a good postoperative recovery. Spontaneous perforation of an ovarian dermoid cyst, without an associated torsion, is extremely rare, but it should be considered in cases of peritonitis and bowel obstruction of unclear cause with a concomitant finding of a dermoid cyst.

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Ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration

et al. 2019

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Ovarian dermoid presenting as acute intestinal obstruction: a rare case report and review of literature

Cited by 10 publications

References 9 publications

Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report

Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report

Generalised purulent peritonitis and small bowel obstruction due to a spontaneously perforated ovarian dermoid cyst

Ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration

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