The Prevention of Peritoneal Adhesions by the Use of Citrate Solution

Pope, Saxton T.

doi:10.1097/00000658-191602000-00011

Annals of Surgery

1916

DOI: 10.1097/00000658-191602000-00011

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The Prevention of Peritoneal Adhesions by the Use of Citrate Solution

Saxton T. Pope¹

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Cited by 7 publications

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“…The relatively low concentration of citrate and its rapid elimination from the peritoneal cavity may, however, imply that the impact on some calcium-dependent processes is insignificant or transient. Very little is documented about intra-abdominal citrate administration; however, a known effect of citrate is inhibition of postsurgical peritoneal adhesions (6). Adhesions originate from fibrin clots reorganized by connective tissue formation (7).…”

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Catheter Patency and Peritoneal Morphology and Function in a Rat Model of Citrate-Buffered Peritoneal Dialysis

Cavallini

Braide

2009

Perit Dial Int

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Catheter Patency and Peritoneal Morphology and Function in a Rat Model of Citrate-Buffered Peritoneal Dialysis

Cavallini

Braide

2009

Perit Dial Int

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Lipogranuloma of the Peritoneum

Whitaker¹

1948

JAMA

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Many agents have been employed for the prevention of postoperative intra-abdominal adhesions. During the first two decades of this century, sterile oils were frequently introduced into the peritoneal cavity for this purpose. Their use in experimental animals led observers of this period to believe that such substances as wool fat, petrolatum and liquid petrolatum would inhibit the formation of adhesions.1 These investigators, however, failed to allow sufficient time before sacrificing their animals, and this led to a false impression that sterile oils not only were harmless but would aid in the prevention of postoperative adhesions. It was later demonstrated that petrolatum and liquid petrolatum (Russian mineral oil) Fig. 1 (case 1 ).-Roentgenogram showing calcified lipogranuloma.were intensely irritating to the peritoneum, were slowly absorbed, if at all, and resulted in the formation of granulomas and adhesions.2 Norris and Davison, in 1934,3 reported 2 patients, demonstrating the complications that follow the use of sterile liquid petrolatum in the abdominal cavity. The roentgenographic observations in most of these cases are characterized by calcareous deposits widely distributed throughout the peritoneal cavity, as seen in cases 1 and 2 reported here. REPORT OF CASES Case 1.-Mrs. E. S., white, aged 65, was admitted to Grady Memorial Hospital May 23, 1947, complaining of cramping abdominal pain, vomiting and obstipation of two days' Fig. 2 (case 1).-Enlargement of roentgenogram showing calcified lipogranuloma.duration. A supracervical hysterectomy had been performed in 1924. Two years later the patient began to have frequent episodes of colicky abdominal pain due to partial intestinal obstruction. During the past twenty years she had been seen frequently in the outpatient department with similar complaints.Examination revealed moderate generalized distention and tenderness of the abdomen. Frequent peristaltic rushes were heard on auscultation, and an occasional visible peristaltic wave was observed. There was considerable induration in both vaginal fornices.Roentgenographic examination of the abdomen showed numerous cystic calcific structures distributed throughout the abdomen, without significant arrangement in their distribution (figs. 1 and 2). Many of these structures were circular in contour; some had a mulberry-like appearance and others a serrated silhouette. They varied in diameter from 1 to 3 cm. The psoas and kidney shadows appeared normal. Several loops of distended small intestine were observed, suggesting the presence of obstruction.A celiotomy was performed on the day of admission. The peritoneum was seen to be extremely thickened, and the entire peritoneal cavity wes obliterated by dense adhesions. There were calcified nodules, varying in size from 0.5 to 3.5 cm., scattered throughout the peritoneal cavity. A loop of dilated small intestine was identified with difficulty, and a blind Witzeltype enterostomy was done. Histologie examination of several nodules showed dense fibrous tissue with met...

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Über Ileus durch verwachsungen und stränge

Flesch-Thebesius¹

1920

Deutsche Zeitschrift f. Chirurgie

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The Prevention of Peritoneal Adhesions by the Use of Citrate Solution

Cited by 7 publications

References 0 publications

Catheter Patency and Peritoneal Morphology and Function in a Rat Model of Citrate-Buffered Peritoneal Dialysis

Catheter Patency and Peritoneal Morphology and Function in a Rat Model of Citrate-Buffered Peritoneal Dialysis

Lipogranuloma of the Peritoneum

Über Ileus durch verwachsungen und stränge

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