Abstract

AbstractTwo cases of starch gronulomatous peritonitis, one symptomatic and one asymptomatic, are presented. Although starch glove powder is usually innocuous, the number of cases of starch peritonitis reported in the literature indicates that it is not always so. The typical syndrome consists of abdominal pain, fever, and signs of peritonitis. The leukocyte count is usually within the normal range, but sometimes easinophilia is present. Signs and symptoms characteristically develop 10 to 40 days after an uneventful operation. The diagnosis can be confirmed by finding starch granules in the tissue and in foreign body giant cells. Reoperation may be avoided by suspecting the syndrome and searching for starch in ascitic fluid obtained by paracentesis. Therapy consists of steroids or an anti-inflammatory agent such as indomethacin.