A Case of an Enterocutaneous Fistula Caused by Sodium Hyaluronate Carboxymethylcellulose Bioresorbable Membrane-induced Intestinal Adhesions

Abstract

【Background】A sodium hyaluronate carboxymethylcellulose bioresorbable membrane (Seprafilm^®) is used frequently to prevent postoperative adhesions. It has been considered as an efficient and a safe tool. We report herein on a case of an enterocutaneous fistula caused by Seprafilm^®-induced intestinal adhesions. 【Case presentation】A 79-year-old male was admitted to our department with an enterocutaneous fistula 42 days after the graft replacement for an abdominal aortic aneurysm. Seprafilm^® had been placed at the time of the previous operation. A repeat laparotomy demonstrated dense adhesions between the small intestine and the abdominal wall. The enterocutaneous fistula and the adhered intestine were resected en-bloc. The pathological examination of the resected small intestine showed diffuse subserosal fibrosis with multinuclear giant cells containing a clear foreign body. It was suggested that a paradoxical inflammatory reaction to Seprafilm^® caused the dense adhesions.【Conclusion】It should be kept in mind that Seprafilm^® may also cause dense adhesions.