Adhesions are formed in the body as repair process response to previously incurred surgery, infection and radiological procedures. Adhesions contain fragments of scar tissues that are arranged between previously damaged tissues. Adhesions are often significant post-operative complications, which predominantly occur in the pelvic and cardiac regions. Many cases of obstructive bowel disorders have been reported after pelvic surgeries due to the presence of abdominal adhesions.
Abdominal adhesions are asymptomatic in most but they gradually produce significant symptoms leading to complications. In case of obstructive diseases, abdominal adhesions result in ischemia of the intestines. Along with the abdominal region, adhesions also occur in the uterus, ovaries, fallopian tubes post cesarean sections, hysterectomy and treatments of pelvic inflammatory disease. Adhesions in the heart cause conditions such as rheumatic fever by affecting the pericardial region of the heart. It also causes damage to the valves in decreasing the cardiac activity resulting in ischemic heart disease.
Clinical manifestations of abdominal adhesions
Abdominal adhesions prevent the movement of intestines by adhering to their surfaces. Adherence of these adhesions gradually results in the formation of fiber-like structures along the intestinal region constricting the blood flow leading to the onset of tissue necrosis and inflammation. Abdominal adhesions occur as a result of surgical procedures. Some of the predisposing factors include the handling of the internal organs during surgeries, incisions, preexisting infections, and contacts with surgical instruments and absorbent materials such as gauze and cotton swabs which dry the tissues, remnants of blood clots after the surgical procedure and radiation. Other factors include appendicitis.
Symptoms of abdominal adhesions include vomiting, constipation, improper bowel movement, bloating and abdominal swelling. The classical symptom indicating the presence of abdominal adhesions is chronic abdominal pain followed by gastrointestinal bleeding. These symptoms are further correlated with the patient's history associated with previous surgical procedures.
Diagnosis and prevention
Abdominal adhesions can only be detected using laparoscopic procedure. However, X rays determine the presence of intestinal obstructions. Hence abdominal surgeries are only recommended when it is absolutely necessary. Abdominal adhesions can only be prevented by administering minimal invasive procedures such as laparoscopy. In cases of surgeries that require large incisions, a thin absorbable material called seprafilm is placed between the tissues to prevent the occurrence of adhesions. Seprafilm is gradually digested by the tissue fluids. Many studies indicate that the usage of latex free gloves can prevent adhesions to a greater extent. Tissue rehydration is very important during surgical procedure to prevent abdominal adhesions.
Treating of Abdominal adhesions
Abdominal adhesions are removed surgically followed by analgesic medication. An alternative to surgery in the treatment of these lesions includes the administration of complementary and alternative medicine (CAM). The CAM procedure consists of methodologies such as acupuncture and physical therapy.
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Bibliography / Reference
Collection of Pages - Last revised Date: February 28, 2024