title: Peritoneal adhesions and intestinal obstructions in patients with familial Mediterranean fever--are they more frequent?
abstract: OBJECTIVE
  Familial Mediterranean fever (FMF) is characterized by recurrent episodes of peritonitis. A controversy exists as to whether intestinal obstruction due to peritoneal adhesions is more common among FMF patients compared with healthy controls. The aim of the study was to estimate the rate of spontaneous or postsurgical small-bowel obstruction (SBO) in FMF patients.
  
  
  METHODS
  We reviewed the charts of 560 FMF patients followed in our clinic for the occurrence of spontaneous SBO. We also assessed the occurrence of postappendectomy intestinal obstruction among 89 FMF patients compared with 417 individuals without FMF who underwent an appendectomy without other abdominal surgery in the same medical center.
  
  
  RESULTS
  Ten of 471 FMF patients (2.1%) developed spontaneous SBO, 8 of whom required laparotomy and adhesiolysis. Six of 89 FMF patients (6.7%) who underwent appendectomy developed SBO. None of the non-FMF patients developed SBO.
  
  
  CONCLUSIONS
  Our retrospective study showed that FMF patients are at a higher risk than healthy individuals for developing SBO either spontaneously or as a postsurgical complication. Physicians should be alert to this possible complication when FMF patients arrive at the emergency room.
authors.affiliation: Department of Pediatrics, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. berkun@md.huji.ac.il
authors.forename: Yackov
authors.initials: Y
authors.lastname: Berkun
authors.forename: Eli
authors.initials: E
authors.lastname: Ben-Chetrit
authors.forename: Aharon
authors.initials: A
authors.lastname: Klar
authors.forename: Eldad
authors.initials: E
authors.lastname: Ben-Chetrit
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000009:adverse effects*; D001064:Appendicitis / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D002648:Child; D010505:Familial Mediterranean Fever / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D007557:Israel / Q000453:epidemiology; D008297:Male; D010538:Peritonitis / Q000209:etiology* / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology