The effect of oral d-penicillamine on intraperitoneal adhesions

Abstract EN

Objectives : The most common cause of intraperitoneal adhesion bands is previous abdominal surgery.

Postoperative adhesion formation results from a fibro proliferative inflammatory reaction.

The possibility of involvement of fibrogenic process in adhesion formation and the antifibrogenic effect of D-penicillamine led us to test the effectiveness of this drug as a possible preventive method for intraperitoneal adhesions.

Methods : Eighty female rats were randomly divided into four equal groups of 20 rats.

Generation of adhesion in rats introduced by intra peritoneal injection of 2.5 milliliter of a 10% sterile talc solution.

The first group served as control, group 2 received oral D-penicillamine 35 milligram per kilogram per day, group 3 received oral colchicines 0.02 milligram per kilogram per day and group 4 received both drugs for three weeks.

Formation of adhesion bands was then quantitatively graded in each group according to Nair classification.

Results : Severe adhesions (grade 3 and 4) were found in 20% of the D-penicilliamine administered group (group 2), whereas these types of adhesions were observed in 33% and 84% of colchicine administered groups (group 3) and the control group (group 1) respectively (p < 0.003).

Group 4 that had received both D-penicillamine and colchicine was omitted from the study due to a high mortality rate.

Adhesion bands in D-penicillamine group were thinner and smoother in comparison to other groups.

Conclusion : Lower grades of adhesions were found in the D-penicillamine group in comparison to the colchicine and control groups.

Therefore it seems that D-penicillamine may be effective in the prevention of formation of adhesion bands in the rat.