Postoperative small bowel obstruction associated with use of hemostatic agents.
A case of early postoperative small bowel obstruction (SBO) after intraoperative use of hemostatic agents during laparoscopic staging for endometrial cancer is reported. A 46-year-old woman underwent a laparoscopic staging procedure for endometrial cancer during which hemostatic agents were used in the management of an iatrogenic injury to the inferior vena cava. The patient returned on postoperative day 6 with SBO and was taken to the operating department. She required a small bowel resection in the specific area where the hemostatic agents were used. Pathology showed extensive fibrotic changes caused by a foreign material that was suggestive of a thrombin-related product. Use of hemostatic agents should be considered as a cause in the differential diagnosis of patients with early postoperative SBO.
Hobday
Christopher D
CD
Department of Obstetrics and Gynecology, The University of Texas at Houston, USA.
Milam
Michael R
MR
Milam
Rebecca A
RA
Euscher
Elizabeth
E
Brown
Jubilee
J
D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects*; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods; D000267:Tissue Adhesions / Q000150:complications / Q000473:pathology; D014682:Vena Cava, Inferior / Q000293:injuries
C411004:FloSeal Matrix; D006490:Hemostatics