長期経過を観察しえた虫垂炎術後スターチ腹膜炎の1例

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  • A Case of Starch Peritonitis after Appendectomy Followed for a Long Time

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At age 16 an appendectomy was performed for acute appendicitis with perforation. Postoperatively high fever continued for 9 days, she had stomachache and vomited. We judged this to be due to a small bowel obstruction, and inserted a long decompression tube. Laparoscopic adhesiolysis was performed on the 12th day. There was yellowish muddy ascites, and small white nodules were observed on the peritoneum. The ascites culture was negative. After the second operation, high fever and inflammation continued. A large amount of ascites and swelling of the mesentery was recognized on CT. An intradermal test performed with the powder of gloves was positive. We diagnosed starch peritonitis and administered a steroid hormone. The inflammatory reaction fell promptly, and the ascites also disappeared on the CT scan. She was hospitalized due to ileus 2 years later, but this was resolved without an operation. She was treated for a stomachache 3, 7 and 12 years after the operation. There was no need for an operation. We think that the low diffusion of powder-free gloves in Japan is still a problem. We should ban the use of powdered surgical gloves that may cause adverse reactions.

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