title: Acute inflammatory reaction following placement of sodium hyaluronate-carboxymethylcellulose barrier in a young woman undergoing gynecologic surgery: a case report.
abstract: BACKGROUND
  Hyaluronate-carboxymethylcellulose (HA-CMC) is commonly used to inhibit adhesion formation in women undergoing gynecologic surgery.
  
  
  METHODS
  A 38-year old woman underwent a bilateral salpingo-oophorectomy for the indication of persistent pelvic pain following a hysterectomy, an ovarian cyst and endometriosis. HA-CMC was placed at the time of surgery. The patient returned to the operating room on postoperative day 3 with an acute inflammatory reaction and small bowel obstruction. A mast cell infiltrate and acute serosal damage was observed on final histopathology of the resection portion of small bowel.
  
  
  CONCLUSIONS
  Few case reports describing adverse events with the use of HA-CMC have been published. This patient appears to have had a paradoxical inflammatory reaction to this adhesion barrier.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Maryland Women's Health, Stapa Building, 3rd Floor, 11 South Paca Street, Baltimore, MD 21201, USA. stemkin@upi.umaryland.edu
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Temkin
authors.forename: Jerrold R
authors.initials: JR
authors.lastname: Turner
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Lengyel
mesh_terms: D000328:Adult; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects* / Q000627:therapeutic use; D004715:Endometriosis / Q000601:surgery; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D007044:Hysterectomy / Q000009:adverse effects; D007249:Inflammation / Q000209:etiology*; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000293:injuries / Q000473:pathology / Q000601:surgery; D008407:Mast Cells / Q000473:pathology; D010048:Ovarian Cysts / Q000601:surgery; D010052:Ovariectomy / Q000009:adverse effects; D017699:Pelvic Pain; D011183:Postoperative Complications / Q000209:etiology; D058994:Salpingectomy / Q000009:adverse effects; D000267:Tissue Adhesions / Q000150:complications / Q000517:prevention & control* / Q000601:surgery
chemical_list: D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium