Starch granulomatous peritonitis caused by starch deposited by surgeons' gloves resulted in reoperation on three patients. The diagnosis was made from histological sections of biopsies which showed starch granules within foreign body giant cells. Peritoneal fluid was also found to contain many typical starch granules, identified by staining properties and the Maltese cross configuration, which is seen when the granules are viewed through crossed polarizing filters. Anti-inflammatory steroids were administered to two of the patients with dramatic improvement. Starch continues to be the most commonly employed nonstick agent in the manufacture of sterile gloves, and it must be removed before operating if starch peritonitis is to be avoided. The complication appears to be the result of a hypersensitivity reaction and is best treated nonsurgically.
Coder DM, Olander GA. Granulomatous Peritonitis Caused by Starch Glove Powder. Arch Surg. 1972;105(1):83-86. doi:10.1001/archsurg.1972.04180070081017