Granulomatous peritonitis induced by talc and cellulose fibers
Keywords:
granuloma, peritonits, talc, necrosis, lubrification, gloves surgicalAbstract
Peritoneum reacts to foreign bodies in a spectral way, according to the kind of material involved. The most common form of reaction is granuloma to talc. which is a source of considerable diagnoses problems, in some cases simulating tuberculosis and carcinomatosis. Talc was used in the past as a donning powder in surgical gloves. Patients often develop ascites, micronodules and adhesions. Cellulose fibers, which reach peritoneum through surgical clothes and masks, can also induce granulomatous peritonitis. The present study aimed to report a case of a patient that was found to have peritoneal micronodules and some adhesions during a laparoscopic cholecystectomy. She had a previous laparotomy for apendicectomy and a small intestine surgery. The histological examination demonstrated tuberculous granulomas with central caseous necrosis showing a brown and filamentous
material (similar to cellulose fibers), and, with polarization, a great number of crystals (silica). Special staining for fungus and BAAR resulted negative, which excluded infectious process. No sign of carcinomatosis was demonstrated by the histological examination. There was no symptoms, despite the exuberant laparoscopic presentation.
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