Acute chemical peritonitis secondary to ovarian dermoid rupture: a rare complication

Abstract

A dermoid cyst is also known as a mature cystic teratoma and is one of the most common ovarian germ cell tumors of women, particularly in the premenopausal age group. This tumor is composed of skin, hair, teeth and sebum, enclosed in a fibrous tissue. A ruptured dermoid cyst can be missed and can have serious morbidity, and imaging modality can help in the diagnosis, as was done in this case. A 42-year-old parous woman presented with acute onset, vague, lower abdominal pain. The patient had a history of acute onset abdominal pain for two days, that worsened. An ultrasound followed by CT scan revealed a dermoid cyst that had ruptured following which an exploratory laparotomy was done, which confirmed the finding. Although a dermoid cyst is the most common ovarian germ cell tumor, a ruptured ovarian dermoid cyst is a very infrequent complication. The resulting peritonitis from the rupture often presents with acute or chronic peritonitis. A good clinico-radiological  correlation can help us come to a diagnosis and lead us to the surgical intervention that is required. A ruptured dermoid cyst can present with vague symptoms. A high degree of suspicion is required to lead us to the timeliest surgical intervention.