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[卵巢皮样囊肿腹腔镜手术后的肉芽肿性腹膜炎。诊断、处理、预防,病例报告]

[Granulomatous peritonitis after laparoscopic surgery of an ovarian dermoid cyst. Diagnosis, management, prevention, a case report].

作者信息

Huss M, Lafay-Pillet M C, Lecuru F, Ruscillo M M, Chevalier J M, Vildé F, Taurelle R

机构信息

Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Boucicaut, Paris.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1996;25(4):365-72.

PMID:8815134
Abstract

We report a case of granulomatous peritonitis which occurred following laparoscopic exeresis of a dermoid cyst of the ovary performed together with medically induced abortion. The peritoneal cavity was contaminated when the cyst ruptured during the procedure emptying sebum and hairs in the peritoneum. Abondant washing with aspiration of all the visible particles was done with a 5 mm canula. The diagnosis of granulomatous peritonitis was suggested with the development of persistant fever, degradation of the patient's general health, moderate abdominal pain and a nodular image at echography located on the operated ovary. The nodule was found to be an inflammatory granuloma on a foreign body. Two second-look laparotomies, one transrectal and the other via the xypho-pubian route, were required 1 month after the initial operation for complete cure. The diagnosis was confirmed on the pathology report.

摘要

我们报告一例肉芽肿性腹膜炎病例,该病例发生在腹腔镜切除卵巢皮样囊肿并同时进行人工流产之后。手术过程中囊肿破裂,皮脂和毛发排入腹腔,导致腹腔污染。用5毫米套管进行了大量冲洗并吸出所有可见颗粒。持续发热、患者总体健康状况恶化、中度腹痛以及超声检查显示手术侧卵巢有结节影像,提示肉芽肿性腹膜炎诊断。发现该结节为异物性炎性肉芽肿。初次手术后1个月需要进行两次二次剖腹探查,一次经直肠,另一次经剑突耻骨途径,以实现完全治愈。病理报告证实了诊断。

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