Diagnosis and Management of a Spontaneously Ruptured Ovarian Mature Cystic Teratoma: A Case Report

Abstract

Aims: Spontaneous rupture of an ovarian mature cystic teratoma is a very uncommon event. Rupture of ovarian teratoma causes leakage of the liquefied sebaceous contents into the peritoneum, which irritates the peritoneum and leads to acute or chronic inflammation associated with chemical peritonitis. Case Presentation: We report a case of a 23 year old unmarried woman who presented with abdominal pain, distension and fever. The CT scan showed a thick irregular cystic lesion in the pelvis of approximately 11×8 cm with features suggestive of dermoid cyst. There was focal defect in the superior aspect of the wall of the cyst which appeared to be the likely rupture site along with features suggestive of chemical peritonitis. She underwent emergency laparotomy followed by right side salpingo-oophorectomy, adhesiolysis, and peritoneal lavage. Postoperatively, she developed paralytic ileus which was managed conservatively and chest infection was treated with antibiotics and physiotherapy. She also developed surgical site infection which was managed with antibiotics and daily dressing. She was discharged on the 48th postoperative day in a good state of health. Conclusions: This case report shows the advantages of early diagnosis and management of ruptured ovarian mature cystic teratoma which otherwise could have led to increased morbidity associated with chemical peritonitis.