Restricted accessReview articleFirst published online 2012-02
A Case of Icodextrin 4% (Adept ® ) Induced Aseptic Peritonitis After a Cesarean Section and a Review of the Side-Effects of this Adhesion-Preventing Solution in Gynecologic Surgery
Background: Adhesion-preventing solutions are often used in gynecologic surgery and cesarean sections. Case: A case of aseptic peritonitis, following a cesarean section, after the use of the adhesion-preventing solution icodextrin 4% (Adept®) is presented. Simultaneously, a review of the relevant literature, with emphasis on the solution's side-effects, is performed. Results: Progressive improvement of the patient's clinical condition was noted over the next few days and the patient was discharged. Conclusions: Side-effects of this chemical substance should be known and not overlooked when using it. (J GYNECOL SURG 28:70)
Get full access to this article
View all access options for this article.
References
1.
HosieK, GilbertJA, KerrD, BrownCB, PeersEM. Fluid dynamics in man of an intraperitoneal drug delivery solution: 4% icodextrin. Drug Deliv, 2001; 8:9.
2.
diZeregaGS, VercoSJ, YoungP, KettelMet al.A randomized, controlled pilot study of the safety and efficacy of 4% icodextrin solution in the reduction of adhesions following laparoscopic gynaecological surgery. Hum Reprod, 2002; 17:1031.
3.
Adept.® Information for Prescribers. Deerfield, IL: Baxter, 2010.
4.
VercoSJ, PeersEM, BrownCB, RodgersKE, RodaN, diZeregaG. Development of a novel glucose polymer solution (icodextrin) for adhesion prevention: Pre-clinical studies. Hum Reprod, 2000; 15:1764.
5.
BrownCB, LucianoAA, MartinD, PeersE, ScrimgeourA, diZeregaGS. Adept Adhesion Reduction Study Group. Adept (icodextrin 4% solution) reduces adhesions after laparoscopic surgery for adhesiolysis: A double-blind, randomized, controlled study. Fertil Steril, 2007; 88:1413.
6.
MetwallyM, WatsonA, LilfordR, VandekerckhoveP. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev, 2006; 2:CD001298.
7.
MenziesD, PascualMH, WalzMK, DuronJJ, TonelliF, CroweA, KnightA. ARIEL Registry. Use of icodextrin 4% solution in the prevention of adhesion formation following general surgery: From the multicentre ARIEL Registry. Ann R Coll Surg Engl, 2006; 88:375.
8.
KwasnickaLE, PenkethR. Gross vulval edema after laparoscopic instillation of 4% icodextrin solution. J Minim Invasive Gynecol, 2008; 15:99.
9.
SantosLM, FrennaV, ThomaV, WattiezA. Disseminated intravascular coagulation after laparoscopic multiple myomectomy with use of icodextrin: A case report. J Minim Invasive Gynecol, 2006; 13:480.
10.
DiehA, YassinA, PickersgillA. Extravasation of 4% icodextrin solution (Adept) following laparoscopic pelvic surgery. J Obstet Gynaecol, 2005; 25:489.
ToureF, LavaudS, MohajerM, LavaudFet al.Icodextrin-induced peritonitis: Study of five cases and comparison with bacterial peritonitis. Kidney Int, 2004; 65:654.
13.
MartinJ, SansoneG, CirugedaA, Sánchez-TomeroJA, MuñozC, SelgasR. Severe peritoneal mononucleosis associated with icodextrin use in continuous ambulatory peritoneal dialysis. Adv Perit Dial, 2003; 19:191.
14.
MartisL, PatelM, GiertychJ, MongovenJet al.Aseptic peritonitis due to peptidoglycan contamination of pharmacopoeia standard dialysis solution. Lancet, 2005; 365:588.
PoulopoulosV, LamL, CugelmanA. Sterile peritonitis due to icodextrin: Experience from a Canadian center. Perit Dial Int, 2004; 24:88.
17.
VychytilA, RemónC, MichelC, WilliamsPet al.Extraneal Peritonitis Study Group icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: A 2-year multicentre, comparative, prospective cohort study. Nephrol Dial Transplant, 2008; 23:3711.
