Food Starch-induced Foreign Body Granuloma Formation After Gastric Perforation That Mimicked Peritoneal Dissemination

Abstract

We report a case of food starch-induced foreign body granuloma formation after gastric perforation. The lesions appeared as small white nodules and were indistinguishable from peritoneal dissemination. A 58-year-old woman was admitted to our hospital with a history of abdominal pain and distention. Endoscopy revealed a large ulcer in the lesser curvature of the stomach, and CT showed fluid accumulation with free air on the ventral aspect of the stomach. We diagnosed the condition as an abscess secondary to perforation of a gastric ulcer and performed laparoscopic abscess drainage, followed by closure of the perforation site. Intraoperatively, we observed small white nodules in the abdominal cavity and suspected peritoneal dissemination. However, histopathological evaluation of biopsy specimens from the peritoneal nodules showed food starch-induced formation of foreign body granulomas. Clinicians should bear in mind the possibility of food starch-induced foreign body granuloma formation in the differential diagnosis, besides peritoneal dissemination, of patients with intra-abdominal nodules and a history of gastrointestinal perforation. Histopathological confirmation of the diagnosis is essential.