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Case report
Generalised purulent peritonitis and small bowel obstruction due to a spontaneously perforated ovarian dermoid cyst
  1. Constantinos Simillis1,2,
  2. Emily Cribb1,
  3. Yulia Gurtovaya3 and
  4. Nikhil Pawa1
  1. 1Department of Colorectal Surgery, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  2. 2Department of Surgery and Cancer, Imperial College, London, UK
  3. 3Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Mr Constantinos Simillis; csimillis{at}gmail.com

Abstract

We outline the narrative of a 28-year-old woman who initially presented to the emergency department with vomiting, diarrhoea, abdominal pain and fever. Blood tests revealed significantly raised inflammatory markers and acute renal failure. Initially, this was attributed to gastroenteritis due to a recent foreign travel, but further investigations and radiological imaging revealed a large right ovarian dermoid cyst with a significant amount of free intra-abdominal fluid and small bowel dilation. She underwent laparotomy, which revealed a spontaneously perforated right ovarian dermoid cyst resulting in generalised purulent peritonitis and small bowel obstruction due to bowel adherence at the perforation site. Meticulous adhesiolysis, right salpingo-oophorectomy and extensive peritoneal lavage were performed, with a good postoperative recovery. Spontaneous perforation of an ovarian dermoid cyst, without an associated torsion, is extremely rare, but it should be considered in cases of peritonitis and bowel obstruction of unclear cause with a concomitant finding of a dermoid cyst.

  • small intestine
  • obstetrics and gynaecology
  • gastrointestinal surgery
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Footnotes

  • Contributors CS: clinical and surgical management of the patient, perioperative care of the patient, conception and design of the study, acquisition of patient consent, literature search, acquisition and interpretation of data and figures, drafting the article and final approval of the article. EC: clinical and surgical management of the patient, perioperative care of the patient, acquisition of patient consent, literature search, acquisition and interpretation of data and figures, drafting the article and final approval of the article. YG: clinical and surgical management of the patient, perioperative care of the patient, interpretation of data and figures, article revision and final approval of the article. NP: clinical and surgical management of the patient, perioperative care of the patient, interpretation of data and figures, article revision and final approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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