Table of Contents
What Are Abdominal Adhesions?
The formation of scar tissue and adhesions is a normal process during healing after any surgery and often cause no problems. However, in some cases following abdominal surgery, this fibrous tissue may cause the bowel to stick together. This results in the partial or complete blockage of that particular segment, which leads to death in about five percent of patients.
Sometimes, the obstructed area may become blocked and unblocked repeatedly, causing occasional symptoms. In 10 percent of patients, the obstructed segment twists around the adhesions, becoming "strangulated" and hence deprived of blood flow. If prolonged, this strangulation may result in the death of that segment of the bowel.
Partial obstructions may cause recurring abdominal discomfort and symptoms such as nausea and bloating.
What Causes These Adhesions?
Multiple abdominal or pelvic surgeries represent the most common cause of abdominal adhesions, particularly when the organs are temporarily re-routed or reattached by the surgeon. Other causes include:
- Peritonitis - infection of the membrane covering the abdominal organs
- Endometriosis - inflammation of the lining of the uterus that may affect the abdomen as well
- Appendicitis - inflammation of the appendix
- Ulcerative colitis - inflammation of the intestine
- Gastroenteritis - stomach flu
- Congenital fibrous band (from birth)
- STD (sexually transmitted disease, especially in the case of women
Signs, Symptoms And Complications
Partial adhesions often do not cause permanent symptoms and may even go unnoticed. The episodes of bowel obstruction or abdominal cramps are usually ignored by patients, who may think they are just experiencing an abdominal spasm for some reason. More significant intestinal obstructions may cause the following:
- Severe cramping and abdominal pain
- Nausea and vomiting
- Abdominal swelling (distention)
- Infrequent or absent bowel movements
- Inability or difficulty in passing gas
- Dehydration (dry skin, mouth and tongue, thirst, decreased urination)
- Systemic illnesses (fever, increased heart rate and blood pressure)
- Infertility (in women, abdominal surgery may dislocate the fallopian tubes, increasing the chances of ectopic pregnancies and repeated miscarriages)
Eleven to 20 percent of abdominal adhesion cases are complicated. Several factors are known to complicate abdominal adhesion. These factors mainly include an inexperienced surgeon, improper diet, and an ignorant patient.
How Is The Condition Diagnosed?
In the case of abdominal or pelvic pain, the surgeon will perform a physical examination. This includes pressing and feeling around the abdomen to check for any tenderness. Medical history is recorded as well to establish any similar or related complaints.
If there are complaints of fertility problems, a gynecologist will be brought in for a more specific and detailed abdominal and pelvic examination.
A confirmatory diagnosis involves looking inside the body. This may be done via:
- Imaging Studies: X-rays (barium swallow and meal), CT-Scan or MRI.
- Laparoscopy: a minimally invasive procedure that involves inserting a laparoscope into the abdomen or pelvis (through minor incisions) to take a look inside. However, this procedure carries the risk of aggravating the problem.