An adhesion is a band of scar‐like tissue that develops between two surfaces within the body, fusing them together. They may be very thin and translucent, or can be thick and fibrous. This tissue develops when the body’s repair mechanisms respond to a tissue disturbance in the body, such as during a surgery, infection, or trauma.
Abdominal adhesions are common post‐surgical occurrences, which can be found in approximately 93 percent of women who have abdominal or pelvic surgery. Adhesions in the intestinal tract cause more than half of all small bowel obstructions, and are also believed to contribute to the development of chronic pelvic pain. Adhesions typically begin to form immediately after surgery, however they may not show symptoms for months or years.
Pelvic adhesions can occur after abdominal or vaginal surgery, and can involve any organ within the pelvis. Sexually transmitted infections can lead to adhesions in the fallopian tubes. Fallopian adhesions can lead to infertility and increase the chance of ectopic pregnancy, in which a fetus develops outside the uterus, such as in the fallopian tubes, ovaries and other organs.
Symptoms of Adhesions
The most common symptom of adhesions is pain, caused by nerves pulling on an organ or by the adhesion itself. For example, adhesions over the liver may cause pain with deep breathing and intestinal adhesions may cause pain during exercise or while stretching. Some pelvic adhesions may cause pain during intercourse.
Diagnosis & Treatment
Depending on individual symptoms, a series of tests can determine whether or not adhesions are suspected. An abdominal x-ray may reveal small obstructions that could be caused by adhesions. Many adhesions can be found using scopes to examine affected organs or parts of the body. In some cases, MRI evaluations are recommended. In situations where the diagnosis is questionable, exploratory surgery can help the doctor make a definite diagnosis.
Adhesions in the abdomen and pelvis can be treated and removed laparoscopically which has numerous benefits over traditional surgery. The laparoscope provides excellent visualization and magnification of adhesions and affected organs. Additionally, the carbon dioxide gas used to inflate the abdomen naturally expands the abdominal structures, allowing any adhesions to be clearly seen and effectively treated. The microsurgical principles used during laparoscopic surgeries are much more effective in preventing future development of adhesions.