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Granulomatous Peritonitis After Laparoscopic Cholecystectomy

BACKGROUND: Granulomatous peritonitis may indicate a number of infectious, malignant, and idiopathic inflammatory conditions. It is a very rare postoperative complication, which is thought to reflect a delayed cell-mediated response to cornstarch from surgical glove powder in susceptible individuals...

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Detalles Bibliográficos
Autores principales: Famularo, Giuseppe, Remotti, Daniele, Galluzzo, Michele, Gasbarrone, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535791/
https://www.ncbi.nlm.nih.gov/pubmed/23318079
http://dx.doi.org/10.4293/108680812X13462882736015
Descripción
Sumario:BACKGROUND: Granulomatous peritonitis may indicate a number of infectious, malignant, and idiopathic inflammatory conditions. It is a very rare postoperative complication, which is thought to reflect a delayed cell-mediated response to cornstarch from surgical glove powder in susceptible individuals. This mechanism, however, is much more likely to occur with open abdominal surgery when compared with the laparoscopic technique. METHODS: We report a case of sterile granulomatous peritonitis in an 80-y-old female after a laparoscopic cholecystectomy. Management was conservative, and no relapse was observed after over 1-y of follow-up. DISCUSSION: We propose that peritoneal exposure to bile acids during the laparoscopic removal of the gallbladder was the trigger of granulomatous peritonitis in this patient. Severe complications, such as peritoneal adhesions, intestinal obstruction, and fistula formation, were observed, but no fatalities were reported. CONCLUSION: We should be aware of this rare cause of peritonitis in the surgical setting.