Adhesions in the abdomen:
Normally, organs and abdominal tissues have surfaces that are slippery, preventing them from sticking together. But these abdominal adhesions are fibrous tissue bands resulting in organs and tissues to stick together in the abdominal cavity. Surgeries in the abdomen would result in adhesions causing tissues to stick together.
Location of abdominal adhesions:
- Abdominal cavity is an area between hips and the chest of the body. It contains
Adrenal glands and kidneys - Lower part of esophagus, small intestine, stomach and large intestine.
Female reproductive organs, Pancreas, spleen and liver
Abdominal adhesions can tangle, pull or twist the large and small intestines out of their place and result in intestinal obstruction. Bowel obstruction also known as intestine obstruction causes complete or partial blockage of stool or food movement through intestines.
Causes of abdominal adhesion
Abdominal surgeries are the most repeating cause of abdominal adhesions. Surgery related causes include
⦁ Firstly, drying out of tissues and internal organs
- handling of internal organs
- cuts in internal organs
- Thirdly, contact of foreign materials such as surgical gloves, stitches and gauze with internal tissues.
- Finally, blood clots that were not rinsed away during surgery.
Adhesions in the abdomen never occurs without a cause, but can also result from inflammation other than the cause of surgery, such as
- gynecological infections
- appendix rupture
- infections in abdomen
- radiation treatment
Abdominal adhesions without a cause is rare.
WHO ARE AT A RISK OF HIGH FREQUENCY OF ABDOMINAL ADHESIONS
⦁ 90 percent of patients after abdominal surgeries including gynecological and bowel operations are at high chance to develop abdominal adhesions.
⦁ Abdominal adhesions might become severe problem after years of surgery as they turn tighter with time.
What are the symptoms?
Majorly, adhesions cause no symptoms and few times abdominal adhesions twist intestines similar to curve in the garden hose. Surgeries result in partial or complete obstruction in the ingestion years after or shortly after undergoing operations.
Liquid, food, waste and air can’t pass through the body with obstruction. The noticeable signs are bloating, severe abdominal pain with nausea and vomiting.
Diagnosis of abdominal adhesions:
Abdominal adhesions cannot be diagnosed by imaging technology such as CT scans, X-rays and ultrasounds. But they are found by examination of the abdomen through surgeries. Although, computerized topography, gastrointestinal series and abdominal X rays help in diagnosing the bowel obstruction.
Abdominal X rays: uses a small amount of radiation and creates an image that is recorded on film or computer. The X-ray machine is positioned over the abdominal area and the person holds their breath to avoid blurry pictures.
Lower gastrointestinal series (a type of X-ray exam) is used to look for large intestine.
CT scan: a combination of computer technology and X rays to create images. It includes injection of contrast medium, a special dye. X ray is taken as the patient slides into a tunnel-shaped device.
Before undergoing the test the patient is asked by the physician with bowel prep instructions.
To follow clear liquid diet for 1 to 3 days prior to the procedure. An enema or a laxative is used before test as it increases bowel movements and loosens stool. The patient will be inserted with a flexible tube into his/her anus by a radiologist as the person lies on a table. Barium is filled in the large intestines for clear view of underlying problems.
Complications of abdominal adhesions:
They can lead to female infertility (inability to become a pregnant) and intestinal obstruction.
1. Female infertility – prevents eggs that are fertilized to reach the uterus, where development of fetus occurs.
2. High chance of ectopic pregnancy – Abdominal adhesions in women gives high chance of a fertilized egg to grow outside the uterus.
3. Miscarriages – repeated failure of pregnancy within 20 weeks.
Possible treatments for abdominal adhesions:
⦁ Adhesions that cause no symptoms does not require a therapy.
⦁ Health care professional will not recommend surgery until internal blockages become a matter of concern. Since added surgeries will only result in more adhesions.
⦁ Obstructions caused by adhesions
* Acute (complete blockage)
* Chronic (repeated attacks)
are treated only by surgical removal.
Prevention of abdominal adhesions:
These adhesions are hard to prevent but several surgical techniques can reduce them.
1.Laproscopic surgery usually causes smaller cuts in the lower abdomen, decreasing the frequency of abdominal adhesions. And a surgeon cannot completely keep away the patient from abdominal adhesions.
During the procedure a tiny camera is inserted through small incisions and a general anesthesia is given.
2.Open surgery causes more adhesions as it requires larger incisions. These adhesions do not cause any major problems.
Insertion of special filmlike material amidst the organs is absorbed by the body preventing the occurrence of abdominal adhesions by hydrating the organs.
Alternate steps the surgeons should take during surgery
- using gloves that are starch- and latex-free
- moistened drapes and swabs must be used
- occasional application of saline solution
- handling tissues and organs gently and shortening surgery time
Interpretation for people with abdominal adhesions
Sometimes people with severe adhesions in the abdomen would not show any alarming symptoms. Whatsoever, if you experience complete or repeated blockage of bowels after the surgery. You might be in need of an operation by your surgeon.
Time to seek medical care:
A complete bowel obstruction is life-threatening. Take immediate medical attention when you experience any of the following symptoms after surgery:
⦁ Significant belly(abdominal) bloating or swelling.
⦁ Severe cramps or abdominal pain.
⦁ Vomiting or nausea.
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