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What Are Adhesions?

Adhesions are fibrous bands usually formed due to injury during the surgery. These fibrous bands tend to create a sticky bond within the organ or between different organs. This adversely affects the normal functioning of the organs.

Mechanism - How Are Adhesions Formed?

The human body has the inherent ability to repair its damaged cells and tissues. In case of any damage or disturbance, these repair mechanisms tend to heal the damaged tissue by producing certain chemicals. These chemicals form a scar tissue, which in some cases, may form obstructive adhesions.

Post-operative Adhesions

Adhesions that develop during or after a surgery are termed "post-operative adhesions", AKA "post-op adhesions". They may appear either as thin plastic sheets, or as thick fibrous bands, depending upon the extent of tissue damage. Post-op adhesions are particularly common after abdominal and pelvic surgeries. More than 90 percent of patients develop abdominal adhesions following abdominal surgery, and 45-55 percent of women develop pelvic adhesions after a pelvic surgery.

Causes And Risks Of Developing Adhesions

Researches claim that any kind of surgical procedure could predispose an individual to developing adhesions or scar tissue. However, there are some causes, besides surgery, that might result in the formation of adhesions as well.

The most common ones include:

  • Infection
  • Radiation
  • Trauma

Certain individuals, probably due to some inherent or underlying cause, are more likely to develop adhesions as compared to the normal population.

These include:

  • Diabetics - people suffering from diabetes mellitus (type 1 or 2).
  • Asplenic Patients - people without a spleen.
  • HIV/AIDS - patients suffering from autoimmune deficiency syndrome.
  • Operated individuals - people who have had a recent surgery.
It is NOT ALWAYS necessary to have an underlying cause or risk factor for developing adhesions. A young healthy patient may also develop adhesions after a surgical procedure. However, the risk of developing adhesions increases with the number of surgeries a person undergoes.

Regions Where Adhesions Usually Develop

There is no specific region where adhesions develop. However, there are certain regions where adhesions are more likely to develop.

These include:

  • Abdominal Adhesions - anywhere within the abdominal area, usually after abdominal surgery.
  • Pelvic Adhesions - following pelvic surgery.
  • Pericardial Adhesions - fibrous bands in the pericardium (heart muscle) after heart surgery.
  • Adhesive Capsulitis aka "frozen shoulder" - in the shoulder joint, restricting joint movement.

Treatment and Prevention

Most often adhesions resolve spontaneously. However, there are cases in which surgical intervention becomes necessary, especially in the case of an emergency.

This involves:

  • Surgically separating the adhesions - causes the affected organ to regain normal movement and reduces associated symptoms.
  • Placing a barrier at the time of surgery - reduces the chances of recurrence.

Symptomatic treatment involves reducing pain and preventing complications. It includes administering painkillers and antibiotics.

Possible Complications

If left untreated, adhesions can cause severe complications, such as:

  • Complete or partial bowel obstruction (intestinal adhesions)..
  • Irregular menstrual cycles and inability to conceive (adhesions in the uterine cavity).

  • Scarring of the fallopian tubes, leading to reproductive disorders and infertility (pelvic adhesions)
Despite the availability of management choices, for adhesions, preventive strategies are better than treatment options. However, whatever intervention is used, the prognosis is good in most cases.

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