Paradoxical inflammatory reaction to Seprafilm: case report and review of the literature.
This report describes a paradoxical inflammatory reaction to Seprafilm caused by extensive adhesion formation early in the postoperative period. A female patient had development of small bowel obstruction immediately after an uneventful low anterior resection for rectal carcinoma with placement of Seprafilm. The obstruction did not improve with nonoperative therapy. At laparotomy, extensive adhesions necessitating bowel resection and ileostomy were noted. Pathology results showed a giant cell foreign body reaction to Seprafilm. A literature search yielded only two other instances of adverse reactions to Seprafilm. The information provided by this and other atypical reports suggests that further studies aimed at identifying the incidence and pathophysiological mechanisms for such paradoxical reactions are needed.
David
Marianne
M
Department of Surgery and the Department of Pathology, George Washington University, Washington, DC 20037, USA.
Sarani
Babak
B
Moid
Farah
F
Tabbara
Sana
S
Orkin
Bruce A
BA
D000368:Aged; D001672:Biocompatible Materials / Q000009:adverse effects / Q000627:therapeutic use; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D007081:Ileostomy; D007249:Inflammation / Q000209:etiology; D007813:Laparotomy; D009852:Omentum / Q000473:pathology; D011183:Postoperative Complications
D001672:Biocompatible Materials; C118198:Seprafilm; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium