Case Report

Paradoxical Inflammatory Reaction to Seprafilm: Case Report and Review of the Literature

Authors: Marianne David, BS, Babak Sarani, MD, Farah Moid, MD, Sana Tabbara, MD, Bruce A. Orkin, MD, FACS

Abstract

This report describes a paradoxical inflammatory reaction to Seprafilm caused by extensive adhesion formation early in the postoperative period. A female patient had development of small bowel obstruction immediately after an uneventful low anterior resection for rectal carcinoma with placement of Seprafilm. The obstruction did not improve with nonoperative therapy. At laparotomy, extensive adhesions necessitating bowel resection and ileostomy were noted. Pathology results showed a giant cell foreign body reaction to Seprafilm. A literature search yielded only two other instances of adverse reactions to Seprafilm. The information provided by this and other atypical reports suggests that further studies aimed at identifying the incidence and pathophysiological mechanisms for such paradoxical reactions are needed.


Key Points


* Seprafilm has been proven to be a safe and effective adhesion barrier after abdominopelvic surgery.


* Rare adverse inflammatory reactions to Seprafilm indicate that certain predisposing factors might exist that contribute to this phenomenon.


* Given the widespread use of adhesion barriers in abdominopelvic surgical procedures, further experimental studies are warranted for investigating the underlying pathophysiological mechanisms for these aberrant inflammatory reactions.

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