RUPTURED DERMOID CYST: AN EMERGENCY IN GYNAECOLOGICAL PRACTICE
INTRODUCTION:
RUPTURE OF A DERMOID CYST IS A VERY RARE CONDITION DUE TO ITS THICK CAPSULE RESULTING IN
INFREQUENT COMPLICATION SUCH AS ACUTE OR CHRONIC PERITONITIS AND MAY NOT SHOW ANY
CLINICALLY DISTINGUISHABLE FEATURES FROM CYST TORSION.
CASE REPORT:
A 28YEAR OLD WOMEN ADMITTED TO GYNAECOLOGICAL DEPARTMENT WITH 2 DAY HISTORY OF
DULL ACHING PELVIC PAIN INCREASING IN INTENSITY WITH NO HISTORY OF FEVER, NAUSEA,
VOMITING, NO KNOWN AGGRAVATING FACTORS. SHE IS PARA 1 LIVE 1 WITH PREVIOUS VAGINAL
DELIVERY, KNOWN CASE OF DERMOID CYST DIAGNOSED INCIDENTALLY DURING HER ANTENATAL
CHECKUP 2 YEARS BACK. SHE HAS NO RELEVANT MEDICAL OR SURGICAL HISTORY. ON EXAMINATION
-HER VITALS WERE BP-110/70MMHG PR-104BPM SPO2-98% HB- WBC COUNT – ABDOMINAL
EXAMINATION WAS SOFT, WITH REBOUND TENDERNESS+ GUARDING RIGIDITY+, PELVIC
EXAMINATION WAS NOT DONE. HER USG FINDINGS SHOWED RIGHT OVARY WITH THICK-WALLED
CYST MEASURING 5.7 X 4.4 X 5.7CM WITH POSTERIOR acoustic shadowing S/O DERMOID CYST RIGHT
ADNEXA SHOWED WHIRLPOOL SIGN? TORSION OF RIGHT TUBE. SHE WAS PLANNED FOR
LAPAROSCOPIC REMOVAL INTRAOPERATIVELY COPIOUS THICK SEBACEOUS TYPE MATERIAL ALL OVER
THE ABDOMEN WITH FILMSY ADHESIONS ALL OVER ABDOMINAL WALL.SHE WAS MANAGED WITH
DERMOID REMOVAL WITH RIGHT SALPHINGO OPHERECTOMY WITH THOROUGH
PERITONEALWASHINGS. HISTOPATHOGICAL EXAMINATION CONFIRMED THE DIAGNOSIS OF MATURE
CYSTIC TERATOMA .AND ABODMINAL PUS CULTURE SHOWED NO BACTERIAL GROWTH. POST
OPERATIVE WAS UNEVENTFUL AND WAS DISCHARGED ON POD 2.
CONCLUSIONS:
THIS CASE ILLUSTRATES THE CLINICAL IMPLICATIONS AND SURGICAL SOLUTIONS WITH THE HELP OF
RADIOLOGICAL ASSESSMENT