Granulomatous Peritonitis Caused by Starch Glove Powder

The immunogenicity of starch glove powder and talc

“…Unidentified crystals resembling talc had been noted in earlier accounts of starch granulomas (Coder and Olander, 1972;Davies and Neely, 1972), but their inconstant presence did not favour an important role for them. The more sensitive replication technique of Henderson (1 969) showed that talc contamination is more common than was appreciated.…”

Successful Surgical Management of a Severe Case of Starch Peritonitis

“…Partially on the assumption that the reac tion to the starch granules may be a form of hypersensitivity, systemic corticosteroids have been used with some success in the past [1][2][3]5], Good response was reported with indomethacin in a small group of patients [6], However, the time course of the syndrome may be protracted and the morbidity is con siderable. In addition, recognition of this rare postoperative syndrome, so similar to major postoperative abdominal sepsis, on clinical grounds alone is extremely difficult.…”

“…It gives rise to a postoper ative symptom complex which closely mim ics major postoperative septic complication [1][2][3][4][5]. Its incidence in one series of 4,965 intraabdominal procedures was 0.1 % [2], Because this entity is rare and recognition of this postoperative syndrome on clinical grounds alone is difficult, most patients with starch peritonitis have undergone a reexploratory operation.…”

Starch granulomatous peritonitis

“…As was pointed out previously, the most common clinical findings of starch granulomatous peritonitis are paralytic ileus, ascites, abdominal mass and pain associated with fever. In general, these symptoms and physical findings develop after uneventful recovery from an uncomplicated abdominal surgery [10]. The reported interval between the initial surgery and the onset of symptoms is 5 days to 8 years [2].…”

“…In the majority of these patients, however, the symptoms develop in the 2nd to the 5th postoperative week. Starch granulomatous peritonitis is a self-limited disease [10] and thus, most patients recover completely within a 2-6 week period without further surgery. In our case presented here, ileus appeared in the 1st week and more than 5 weeks elapsed before the bowel regained its normal activity.…”