Achtari C, Genolet P M, Bouzourene H, De Grandi P
Département de Gynécologie-Obstétrique, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
Gynakol Geburtshilfliche Rundsch. 1998;38(3):146-50. doi: 10.1159/000022253.
Dermoid cyst is the most frequent benign ovarian tumor. Its intraperitoneal rupture may lead to a peritoneal reaction known as chemical peritonitis. It is a rare but a potentially dangerous issue. Its treatment may need one or more reoperations. We report here the case of a patient operated on in emergency for a torsion of an ovarian dermoid cyst, with peritoneal spillage of its content during coeliosurgery. The prolonged contact between the sebaceous material and the peritoneum has led to a chemical peritonitis. Two more laparoscopic interventions, associated with a systemic anti-inflammatory treatment, were necessary to relieve symptoms. We propose the following attitude to avoid this complication: (1) puncture and drainage of the cyst with a trocar; (2) extraction of the cyst in an endobag, and (3) abundant washout of the peritoneal cavity.
皮样囊肿是最常见的卵巢良性肿瘤。其腹腔内破裂可能导致一种称为化学性腹膜炎的腹膜反应。这是一个罕见但潜在危险的问题。其治疗可能需要一次或多次再次手术。我们在此报告一例因卵巢皮样囊肿扭转而急诊手术的患者，在腹腔镜手术期间其内容物发生了腹腔内溢出。皮脂腺物质与腹膜的长时间接触导致了化学性腹膜炎。需要另外两次腹腔镜干预并结合全身抗炎治疗来缓解症状。我们提出以下措施以避免这种并发症：（1）用套管针穿刺并引流囊肿；（2）将囊肿装入内袋取出；（3）大量冲洗腹腔。
