title: Small bowel obstruction after FloSeal use.
abstract: OBJECTIVE
  FloSeal is a thrombin-gelatin hemostatic matrix that is used to obtain hemostasis. There have been isolated case reports of FloSeal causing bowel obstructions, requiring surgical intervention. We report 3 cases of what we believe were FloSeal-induced small bowel obstructions  (SBO).
  
  
  METHODS
  We present a series of small bowel obstructions after FloSeal use. Our series includes urology, gynecologic oncology, and general surgery cases at the same institution where the product was appropriately used and resulted in the same complication.
  
  
  RESULTS
  FloSeal was used for hemostasis in all patients. In each instance, a small bowel obstruction developed in 7 days to 9 days. All patients were reexplored laparoscopically and found to have an intense inflammatory reaction at the site of the FloSeal. The adhesions were lysed and the obstructions  resolved.
  
  
  CONCLUSIONS
  Although further study is needed, the common factor in all these SBOs was a hemostatic agent. In our and others' series, the time to SBO was 7 days to 9 days. If an early postoperative SBO occurs after FloSeal is used, prompt reexploration should be considered.
authors: b_clapp1@hotmail.com
authors: Benjamin
authors: B
authors: Clapp
authors: Antonio
authors: A
authors: Santillan
mesh_terms: D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects* / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics