Serviços Personalizados
Journal
Artigo
Indicadores
- Citado por SciELO
Links relacionados
- Similares em SciELO
Compartilhar
Medicina (Buenos Aires)
versão impressa ISSN 0025-7680versão On-line ISSN 1669-9106
Resumo
JUANEDA, Ignacio et al. Granulomatous peritonitis due to the starch used in surgical gloves. Medicina (B. Aires) [online]. 2008, vol.68, n.3, pp.222-224. ISSN 0025-7680.
Granulomatous peritonitis due to surgical glove starch is an entity of difficult diagnosis and low incidence. Patients present with abdominal pain, fever and prolonged functional ileus three to four weeks postoperatory of a laparotomy where corn starch as glove's lubricant had been used. In surgical re-exploration both the peritoneum and omentum are widely affected with multiple small white nodules together with peritoneal fluid. Histopathology shows inflammatory tissue with giant multinucleated cells containing bi-refringent cornstarch particles inside. Under polarized light the typical maltese cross appearance of cornstarch is revealed. We present a 54 year old woman admitted with abdominal pain, fever and an unusually prolonged ileus in postoperatory period after a laparotomy. Conventional hysterectomy was performed three months before. At admission, exploratory videolaparocopy was done, in which accidentally distal jejunum was perforated which required laparotomy for enterorraphy. One month after she was re-laparotomized due to persistence of ileus. Granulomatous peritonitis was evidenciated and confirmed by histopathology. Endovenous hydrocortisone was given during two weeks and shifted to oral prednisone during four weeks with gradual diminution until suppression. Patient is asymptomatic at seven months of postoperatory. Corticosteroid treatment is an efficient choice. The prevention is crucial and is based on the employment of starch free surgical gloves.
Palavras-chave : Peritonitis; Cornstarch; Surgical gloves.