Case Report

Spontaneously Ruptured Dermoid Cysts and Their Potential Complications: A Review of the Literature with a Case Report

Table 3

Outcomes of dermoid cyst rupture from the reported cases with comparisons between the method of original management of laparotomy vs laparoscopy. Some cases had more than one complication.

ComplicationsCases and percentagesRates of complications encountered on laparotomyRates of complications encountered on laparoscopy

No complications36/88 (41%)324

Chemical/granulomatous peritonitis can present as either or a combination of (1) a histopathological finding of peritoneal biopsies showing peritonitis, (2) an imaging finding of peritoneal thickening/enhancement or perilesional fat stranding, and (3) a surgical finding of dermoid cyst contents overlying entirety of bowel that was still present despite peritoneal irrigation29/88 (33%)
3 cases needed oral steroids to resolve
263

Ileus/bowel obstruction—a clinical finding where the patient does not pass flatus or an imaging finding of dilated bowel loops13/88 (15%)121

Iatrogenic intraoperative bowel perforation—a clinical finding encountered in surgery for ruptured dermoid cysts (cases where the dermoid cyst was found to be perforating into the bowel lumen were not included)4/88 (5%)31, this is from this case that the bowel injury was due to laparoscopic entry

Abscess—an imaging finding of confined collection of suppurative inflammatory material postoperatively after surgery for ruptured dermoid cysts4/88 (5%)3, 1 case did not mention management by laparotomy or laparoscopy0

Haemorrhage—a surgical finding of large amount of blood in intra-abdominal cavity3/88 (3%)30

Death—causes:
(i) from cardiac arrest due to massive internal haemorrhage from ruptured dermoid extending to uterine vessels
(ii) severe sepsis leading to cardiac arrest
(iii) from other injuries with MVA
3/88 (3%)21

Inflammatory dermoid mass recurrence—an imaging finding of calcified mass with necrotic and inflammatory material3/88 (3%)30

Intra-abdominal collection—an imaging finding of accumulation of fluid in the peritoneal cavity postoperatively after surgery for ruptured dermoid cysts3/88 (3%)12

Wound infection—a clinical finding of pus discharge from wound or dehiscence2/88 (2%)20

Disseminated carcinomatosis (from malignant transformation)—a histopathological finding from biopsies in surgery for ruptured dermoid cysts1/88 (1%)01

Residual dermoid fat implants—an imaging finding after surgery for dermoid cysts shown as small solid masses with low signal intensity [25]1/88 (1%)10