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Case Reports
. 2011 Jul-Sep;15(3):361-4.
doi: 10.4293/108680811X13125733356756.

Small bowel obstruction after FloSeal use

Affiliations
Case Reports

Small bowel obstruction after FloSeal use

Benjamin Clapp et al. JSLS. 2011 Jul-Sep.

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.

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References

    1. FloSeal [package insert]. Deerfield, IL: Baxter; 2005
    1. Hobday CD, Milam MR, Milam RA, Euscher E, Brown J. Postoperative small bowel obstruction associated with use of hemostatic agents. J Min Invas Gyn. 2009; 16: 224–226 - PubMed
    1. Thomas PJ, Tawfic SN. Eosinophil-rich inflammatory response to FloSeal hemostatic matrix presenting as postoperative pelvic pain. AJOG. 2009; 200(4): e10–e11 - PubMed
    1. Wilson MS, Hawkswell J, McCLoy RF. Natural history of adhesional small bowel obstruction: counting the cost. Br J Surg. 1998; 85: 1294–1298 - PubMed
    1. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg. 2001; 18: 260–273 - PubMed

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