Shamshirsaz Alireza A, Shamshirsaz Amirhoushang A, Vibhakar Jill L, Broadwell Christina, Van Voorhis Bradley J
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
JSLS. 2011 Jul-Sep;15(3):403-5. doi: 10.4293/108680811X13125733356990.
Dermoid cyst is the most frequent benign ovarian tumor. Spillage of cyst contents during surgery is common and can rarely lead to chemical peritonitis.
A patient presented 3 days after attempted laparoscopic removal of bilateral dermoid cysts. On examination, she had a low-grade fever, rebound tenderness with guarding, and a markedly elevated white blood cell count. A decision was made to proceed with laparoscopy with the presumptive diagnosis of chemical peritonitis. Laparoscopic findings included residual dermoid cyst contents and extensive filmy adhesions of the bowel and omentum to the peritoneal surface. The chemical peritonitis resolved after laparoscopic removal of residual dermoid cyst content including bilateral salpingo-oophorectomy and copious irrigation.
Early recognition and prompt treatment by repeat laparoscopic surgery with removal of the remaining cyst contents and peritoneal lavage can be a successful method for treating chemical peritonitis.
皮样囊肿是最常见的卵巢良性肿瘤。手术过程中囊肿内容物溢出很常见，很少会导致化学性腹膜炎。
一名患者在尝试腹腔镜切除双侧皮样囊肿3天后就诊。检查发现，她有低热、反跳痛伴肌紧张，白细胞计数明显升高。在初步诊断为化学性腹膜炎后，决定进行腹腔镜检查。腹腔镜检查结果包括残留的皮样囊肿内容物以及肠管和大网膜与腹膜表面广泛的薄膜状粘连。在腹腔镜下切除残留的皮样囊肿内容物（包括双侧输卵管卵巢切除术）并大量冲洗后，化学性腹膜炎得到缓解。
通过重复腹腔镜手术早期识别并及时治疗，清除剩余囊肿内容物并进行腹腔灌洗，可能是治疗化学性腹膜炎的一种成功方法。
