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.
| Complications | Cases and percentages | Rates of complications encountered on laparotomy | Rates of complications encountered on laparoscopy |
|---|---|---|---|
| No complications | 36/88 (41%) | 32 | 4 |
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| 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 irrigation | 29/88 (33%) 3 cases needed oral steroids to resolve |
26 | 3 |
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| Ileus/bowel obstruction—a clinical finding where the patient does not pass flatus or an imaging finding of dilated bowel loops | 13/88 (15%) | 12 | 1 |
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| 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%) | 3 | 1, this is from this case that the bowel injury was due to laparoscopic entry |
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| Abscess—an imaging finding of confined collection of suppurative inflammatory material postoperatively after surgery for ruptured dermoid cysts | 4/88 (5%) | 3, 1 case did not mention management by laparotomy or laparoscopy | 0 |
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| Haemorrhage—a surgical finding of large amount of blood in intra-abdominal cavity | 3/88 (3%) | 3 | 0 |
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| 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%) | 2 | 1 |
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| Inflammatory dermoid mass recurrence—an imaging finding of calcified mass with necrotic and inflammatory material | 3/88 (3%) | 3 | 0 |
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| Intra-abdominal collection—an imaging finding of accumulation of fluid in the peritoneal cavity postoperatively after surgery for ruptured dermoid cysts | 3/88 (3%) | 1 | 2 |
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| Wound infection—a clinical finding of pus discharge from wound or dehiscence | 2/88 (2%) | 2 | 0 |
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| Disseminated carcinomatosis (from malignant transformation)—a histopathological finding from biopsies in surgery for ruptured dermoid cysts | 1/88 (1%) | 0 | 1 |
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| 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%) | 1 | 0 |