Exogenous peritonitis.

A syndrome of abdominal pain, intestinal obstruction, weight loss, and fever can be caused by adhesions from granulomatous peritonitis. Contamination of the abdominal cavity at operation by cotton lint from disposable surgical drapes and laparotomy pads appears to be the etiological factor. Exogenous granulomatous peritonitis has been virtually ignored as a cause of postoperative intestinal obstruction, but we recognized three cases in the same community hospital during a 6-month period. Special stains and characteristic morphology identified the offending agent. Some patients may require corticosteroids or nonsteroidal anti-inflammatory drugs, such as indomethacin, to prevent recurrence of the syndrome.