What are abdominal adhesions?
Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs.Abdominal adhesions cause tissues and organs in the abdominal cavity to stick together. Normally, internal tissues and organs have slippery surfaces, preventing them from sticking together as the body moves.
Abdominal surgery is the most frequent cause of abdominal adhesions. Surgery-related causes include
Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries.
How common are abdominal adhesions and who is at risk?
Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs.Abdominal adhesions cause tissues and organs in the abdominal cavity to stick together. Normally, internal tissues and organs have slippery surfaces, preventing them from sticking together as the body moves.- Adhesions are also a major cause of intestinal obstruction and female infertility.
- Although most adhesions cause no symptoms or problems, others cause chronic abdominal or pelvic pain.
Abdominal surgery is the most frequent cause of abdominal adhesions. Surgery-related causes include
- Handling of internal organs
- Cuts involving internal organs
- Contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches
- Drying out of internal organs and tissues
- Blood or blood clots that were not rinsed away during surgery
- Radiation treatment
- Appendix rupture
- Abdominal infections
- Gynecological infections
Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries.
How common are abdominal adhesions and who is at risk?
- 93% of patients who undergo abdominal surgery, develop abdominal adhesions.
- Abdominal adhesions can become larger and tighter as time passes, sometimes causing problems years after surgery.
- Surgery in the lower abdomen and pelvis, including bowel and gynecological operations, carries an even greater chance of abdominal adhesions.
What are the symptoms of abdominal adhesions?
In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common.
Although most abdominal adhesions go unnoticed, the most common symptom is chronic abdominal or pelvic pain. The pain often mimics that of other conditions, including appendicitis, endometriosis, and diverticulitis.
Adhesions that partially block the intestine from time to time can cause intermittent bouts of crampy abdominal pain.
More significant intestinal obstruction can cause the following symptoms:
- Nausea and vomiting
- Severe, crampy abdominal pain
- Inability to pass gas and absent or infrequent bowel movements
- Swelling of the abdomen (abdominal distension)
- Signs of dehydration, including dry skin, dry mouth and tongue, severe thirst, infrequent urination, fast heart rate and low blood pressure.
If the bowel becomes strangulated, people typically develop severe abdominal pain, which can be either crampy or constant. The abdomen is distended and tender when touched even lightly. People with a strangulated bowel usually also develop signs of systemic (body-wide) illness, such as fever, fast heart rate and low blood pressure.
A person with these symptoms should seek medical attention immediately
How can abdominal adhesions cause female infertility?
Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Adhesions can kink, twist, or pull out of place the fallopian tubes, which carry eggs from the ovaries - where eggs are stored and released - to the uterus.
How can abdominal adhesions cause intestinal obstruction?
Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction. An intestinal obstruction partially or completely restricts the movement of food or stool through the intestines. A complete intestinal obstruction is life-threatening and requires immediate medical attention and often surgery.
How are abdominal adhesions and intestinal obstructions diagnosed?
Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. Most abdominal adhesions are found during surgery performed to examine the abdomen. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.
How are abdominal adhesions and intestinal obstructions treated?
A person with these symptoms should seek medical attention immediately
How can abdominal adhesions cause female infertility?
Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Adhesions can kink, twist, or pull out of place the fallopian tubes, which carry eggs from the ovaries - where eggs are stored and released - to the uterus.
How can abdominal adhesions cause intestinal obstruction?
Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction. An intestinal obstruction partially or completely restricts the movement of food or stool through the intestines. A complete intestinal obstruction is life-threatening and requires immediate medical attention and often surgery.
How are abdominal adhesions and intestinal obstructions diagnosed?
Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. Most abdominal adhesions are found during surgery performed to examine the abdomen. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.
How are abdominal adhesions and intestinal obstructions treated?
- Abdominal adhesions that do not cause symptoms generally do not require treatment.
- Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional abdominal adhesions
- Complete intestinal obstructions usually require immediate surgery to clear the blockage. Most partial intestinal obstructions can be managed without surgery.
- Small bowel obstructions that are caused by adhesions require surgery in almost every case.
- When adhesions cause intestinal strangulation, immediate abdominal surgery is required to remove the adhesions so that blood flow to the bowel can be restored.
How can abdominal adhesions be prevented?
Abdominal adhesions are difficult to prevent. However, careful, gentle, surgical techniques can minimize the formation of adhesions.Laparoscopic surgery decreases the potential for abdominal adhesions.
Eating, Diet, and Nutrition role in ABDOMINAL ADHESIONS
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing abdominal adhesions. A person with a partial intestinal obstruction may relieve symptoms with a liquid or low- fiber diet, which is more easily broken down into smaller particles by the digestive system.
Prognosis
Abdominal adhesions can be treated, but they can be a recurring problem. Because surgery is both the cause and the treatment, the problem can keep returning. For example, when surgery is done to remove an intestinal obstruction caused by adhesions, adhesions form again and create a new obstruction in 11% to 21% of cases.
Points to Remember about ABDOMINAL ADHESIONS
- Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs. Abdominal adhesions cause tissues and organs in the abdominal cavity to stick together.
- In most cases, abdominal adhesions do not cause symptoms. When symptoms are present, chronic abdominal pain is the most common.
- Abdominal surgery is the most frequent cause of abdominal adhesions. Of patients who undergo abdominal surgery, 93 percent develop abdominal adhesions.
- A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.
- Surgery is the only way to treat abdominal adhesions that cause pain, intestinal obstruction, or fertility problems.
- Abdominal adhesions cannot be detected by tests or seen through imaging techniques such as x rays or ultrasound. However, abdominal x rays, a lower gastrointestinal (GI) series, and computerized tomography (CT) scans can diagnose intestinal obstructions.