Introduction & Importance: Teratomas, typically situated in midline areas like the sacrococcygeal region, may rarely manifest in the retroperitoneal region. Often asymptomatic and incidentally discovered, they can lead to complications such as infection, tumor rupture, or, exceptionally, peritonitis.

Case Presentation: In a 2-year-old child with a history of trauma, an atypical presentation of acute abdomen and peritonitis was observed. Initial exploration of suspected visceral injury revealed a ruptured teratoma, successfully excised. Post-operatively, the patient remained stable and was discharged.

Clinical Discussion: Clinical presentation of RPTs ranges from simple abdominal pain to abdominal distension or a palpable abdominal mass. Some rare presentations include intraperitoneal hemorrhage or abscess formation. It can be quite challenging for surgeons and is notorious for iatrogenic injuries to surrounding structures. Patients with complete resection of a benign teratoma have an excellent prognosis.

Conclusion: An asymptomatic, undiagnosed teratoma can cause an acute abdomen, as seen in our case where trauma led to tumor rupture, resulting in peritonitis and signs of abdominal distress necessitating prompt surgical intervention to avoid complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625339PMC
http://dx.doi.org/10.1016/j.ijscr.2024.110605DOI Listing

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