Adhesions, General and After Surgery

Adhesions Overview

An adhesion is a band of scar tissue that binds two parts of your tissue that are not normally joined together. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands.

The adhesion develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation. Although adhesions can occur anywhere, the most common locations are within the abdominal cavity, the pelvis, and the heart.

Adhesions Causes

Adhesions develop as the body attempts to repair itself. This normal response can occur after surgery, infection, trauma, or radiation. Repair cells within the body cannot tell the difference between one organ and another. If an organ undergoes repair and comes into contact with another part of itself, or another organ, scar tissue may form to connect the two surfaces.

Adhesions Symptoms

Doctors associate signs and symptoms of adhesions with the problems an adhesion causes rather than from an adhesion directly. As a result, people experience many complaints based on where an adhesion forms and what it may disrupt. Typically, adhesions show no symptoms and go undiagnosed.

Most commonly, adhesions cause pain by pulling nerves within an organ tied down by an adhesion.

These adhesions may trigger waves of cramplike pain in your stomach. This pain, which can last seconds to minutes, often worsens if you eat food, which increases activity of the intestines.
• Once the pain starts, you may vomit. This often relieves the pain.
• Your abdomen may become tender and progressively bloated.
You may hear high-pitched tinkling bowel sounds over your stomach, accompanied by increased gas and loose stools.
• Fever is usually minimal.

• Your bowel stretches further.
• Pain becomes constant and severe.
• Bowel sounds disappear.
• Gas and bowel movements stop.
• Your belly becomes distended.
• Fever may increase.
Further progression can tear your intestinal wall and contaminate your abdominal cavity with bowel contents.

When to Seek Medical Care

See a doctor any time you experience abdominal pain, pelvic pain, or unexplained fever. If you have undergone surgery or have a history of medical illness, discuss any changes in your recovery or condition with your doctor.

Call 911 and go to the nearest emergency department if chest pain occurs.

Exams and Tests

Doctors typically diagnose adhesions during a surgical procedure such as laparoscopy (putting a camera through a small hole into the stomach to visualize the organs). If they find adhesions, doctors usually can release them during the same surgery.

Studies such as blood tests, x-rays, and CT scans may be useful to determine the extent of an adhesion-related problem. However, a diagnosis of adhesions usually is made only during surgery. A physician, for example, can diagnose small bowel obstruction but cannot determine if adhesions are the cause without surgery.

Medical Treatment

Treatment varies depending on the location, extent of adhesion formation, and problems the adhesion is causing. Adhesions frequently improve without surgery. Therefore, unless a surgical emergency becomes evident, a doctor may treat symptoms rather than perform surgery.

Surgery

Two common surgical techniques used to treat abdominal adhesions are laparoscopy and laparotomy.

Next Steps - Follow-up

If you have undergone surgery or have a history of medical illness, always discuss changes in your recovery or condition with your doctor.

Prevention

Steps are taken during surgery to try and minimize the formation of adhesions. Some of these may include: shortening surgical time, keeping the tissues moist, gentle handling of any tissues or organs, and using starch –free and latex- free gloves. Several surgical products have also been developed to try to help prevent adhesions from forming during surgery. Film-like sheets are sometimes used between organs or body surfaces after large, open surgical procedures.

Outlook

Adhesions requiring surgery commonly come back because surgery itself causes adhesions.

Synonyms and Keywords

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