Abdominal adhesions are bands of tissue that form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, which allow them to shift easily as the body moves. Adhesions cause tissues and organs to stick together.
Although most adhesions cause no symptoms or problems, others cause chronic abdominal or pelvic pain. Adhesions are also a major cause of intestinal obstruction and female infertility.
Causes
Abdominal surgery is the most frequent cause of abdominal adhesions. Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries. Adhesions can become larger and tighter as time passes, causing problems years after surgery.
Surgery-induced causes of abdominal adhesions include
* tissue incisions, especially those involving internal organs
* the handling of internal organs
* the drying out of internal organs and tissues
* contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches
* blood or blood clots that were not rinsed out during surgery
A less common cause of abdominal adhesions is inflammation from sources not related to surgery, including
* appendicitis—in particular, appendix rupture
* radiation treatment for cancer
* gynecological infections
* abdominal infections
Rarely, the condition forms without apparent cause.
Symptoms
Although most abdominal adhesions go unnoticed, the most common symptom is chronic abdominal or pelvic pain. The pain often mimics that of other conditions, including appendicitis, endometriosis, and diverticulitis.
When intestinal obstruction occurs, it can cause other symptoms, such as:
* severe abdominal pain or cramping
* vomiting
* bloating
* loud bowel sounds
* swelling of the abdomen
* inability to pass gas
* constipation
A person with these symptoms should seek medical attention immediately.
Diagnosis
No tests are available to diagnose this digestive disorder, and adhesions cannot be seen through imaging techniques such as x rays or ultrasound. Most adhesions are found during exploratory surgery. An intestinal obstruction, however, can be seen through abdominal x rays, barium contrast studies—also called a lower GI series—and computerized tomography.
Treatment Options
Treatment for abdominal adhesions is usually not necessary, as most do not cause problems. Surgery is currently the only way to break adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional adhesions and is avoided when possible.
A complete intestinal obstruction usually requires immediate surgery. A partial obstruction can sometimes be relieved with a liquid or low-residue diet. A low-residue diet is high in dairy products, low in fiber, and more easily broken down into smaller particles by the digestive system.
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Information courtesy of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIH Publication No. 09–5037 January 2009.
Page Last Revised: December 4, 2010
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