卵巣癌術後の汎発性腹膜炎に対し、腹腔鏡下洗浄ドレナージを施行した1例

抄録

Objective: Peritonitis rarely occurs following surgery. Many cases can be cured with antibiotic therapy, but some cases are resistant to conservative treatment.

Case: A 54-year-old female underwent surgery for treatment of ovarian clear cell adenocarcinoma. Intraoperatively, the sigmoid colon was excised due to adhesions related to the left ovarian tumor. Pyrexia continued after surgery; as the symptoms and blood test suggested reoccurrence of inflammation was observed on postoperative day 6, computed topography was performed. Ascites and paralytic ileus were noted; however, no infectious source was identified. Antibiotic administration was initiated. However, since the blood test suggested the inflammatory reaction had worsened, laparoscopic examination was performed on the 14^th postoperative day, which showed intestinal dilation and erythema of the central pelvic peritoneum, and diffuse peritonitis was diagnosed based on the clinical and CT findings and white coating was found within the pelvis but the cause was not identified; therefore, the interior pelvis was cleaned and a drain was placed in the pouch of Douglas and left to provide postoperative drainage. Although the inflammatory reaction recurred on the 6th day after repeat surgery, the inflammation was improved and the patient was discharged on the 14th day after the second operation.

Conclusion: Laparoscopy was beneficial for the treatment of diffuse peritonitis resistant to conservative treatment, following surgery for ovarian cancer.