What is abdominal adhesion?
Abdominal adhesions are bands of fibrous scar tissue that form on organs in the abdomen. They can cause organs to stick to each other or to the abdominal wall.
Abdominal adhesions usually develop after surgery. The abdominal organs, handled by the surgical team, are temporarily relocated from their normal positions. In some people, it provokes excessive formation of scar tissue.
Adhesions can also form in people who develop peritonitis, an infection that has spread to the membrane that covers the abdominal organs. Another uncommon cause is endometriosis. Tissue that normally only lines the uterus grows in other parts of the body, such as inside the abdomen.
In most patients, adhesions do not cause health problems. In a small number of people who have adhesions, however, fibrous bands of scar tissue completely or partially block the intestines. This blockage is called bowel obstruction.
Sometimes, an area of the intestine that is affected by adhesions can become blocked then unblocked, causing symptoms to come and go.
Rarely, a part of the bowel is tightly twisted around a band of adhesive. This twists off the normal blood supply to the bowel, causing what is called “strangulation” and the bowel stream begins to die. When this emergency occurs, the person should be taken in for surgery immediately.
Adhesions are quite rare in patients who have never had abdominal surgery. Adhesions are common in people who have had multiple abdominal surgeries.
Symptoms of Abdominal Adhesions
In most people, abdominal adhesions do not cause any symptoms. Adhesions that partially block the bowel from time to time can cause intermittent bouts of abdominal pain.
More significant bowel obstruction can cause the following symptoms:
- severe, cramping abdominal pain
- nausea and vomiting
- Abdominal bloating (abdominal distension)
- gas and absent or inability to have a bowel movement
signs of dehydration, including dry skin, dry mouth and tongue, severe thirst, frequent urination, rapid heart rate and low blood pressure
If the bowel becomes distended, people usually develop severe abdominal pain, which can be either cramping or continuous. The stomach is distended and tender even when touched lightly. People with a clogged bowel usually develop symptoms of systemic (body-wide) disease, such as fever, rapid heart rate, and low blood pressure.
Abdominal Adhesion Diagnosis
Your doctor will examine you, paying special attention to your abdomen. He will also examine your rectum. If you are a woman, your doctor will do a pelvic exam. To find further evidence for a diagnosis, your doctor will order blood tests and X-rays of your chest and abdomen, and often a CT scan of the abdomen. In some people with suspected bowel obstruction or strangulation, the diagnosis can only be confirmed at the time of abdominal surgery.
Abdominal adhesions of the abdomen are permanent unless the patient has had a surgical procedure called adhesion lysis. During this operation a surgeon uses instruments to clip the fibers that have built up in the adhesions and to remove as much of this scar tissue as possible.
There is no way for you to prevent adhesions. This problem is one reason why doctors are cautious to recommend abdominal surgery only when necessary. If you are having abdominal surgery, your surgeon may reduce the risk of adhesions by using gentle surgical techniques and powder-free gloves.
Small bowel obstructions caused by rugs often require surgery. In cases of partial bowel obstruction or complete bowel obstruction without severe symptoms, surgery may be delayed by 12 to 24 hours to allow the dehydrated patient to receive intravenous (into a vein) fluids and the person to avoid surgery. In this case, a small suction tube that extends through the nose and into the abdomen.
It can be used to prevent excess inflammation and relieve pain and nausea. When adhesions cause strangulation of the intestines, immediate abdominal surgery is needed to remove the adhesions so that blood flow to the bowel can be restored.