Adhesions
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Definition of Adhesions
An adhesion is a band of scar tissue that binds together two anatomic surfaces which are normally separated from each other.
Description of Adhesions
Adhesions are most commonly found in the abdomen, where they form after abdominal surgery, inflammation or injury. Adhesions are fibrous tissues within the body that join normally unconnected parts. Although sometimes present from birth, adhesions are usually scar tissue formed after inflammation. The most common site of adhesions is the abdomen, where they often form after peritonitis (inflammation of the abdominal lining) or following surgery, as part of the body’s healing process. Abdominal adhesions sometimes bind together loops of intestine and can result in intestinal obstruction. This condition is characterized by abdominal pain, nausea, vomiting, abdominal distention, and an increase in pulse rate without a rise in temperature.
Nasogastric intubation and suction may relieve the blockage. If there is no relief, an operation is usually required to cut the fibrous tissue and free the intestinal loops. Although scar tissue within the abdomen can occur after any abdominal operation, they are more common after a ruptured appendix.
Most adhesions cause no problems, but they can obstruct the intestine in about 2 percent of all patients. These obstructions can occur several years later. The adhesions can also block the ends of the fallopian tubes, possibly causing infertility.
Adhesions also occur elsewhere and can be the cause of other disorders – for instance, they can lead to glaucoma when located in the eyes, and when located around the heart can result in pericarditis.
Adhesions can pull on nerves or organs, and depending on where they are located can cause pain in the body while stretching, exercising, or even deep breathing. Doctors can use a number of tests, including blood tests, x-rays and CT scans to determine if the problem is extensive enough to require surgery.
Lysis (destruction or dissolution) of adhesions is a surgery performed to free adhesions from tissues. Laparoscopy (a camera is inserted into a small hole in the skin to view the adhesions and then they are cut) and laparotomy (a larger cut is made and the doctor sees the adhesion directly) are commonly used to treat this condition. The outcome of surgery is usually favorable, although adhesions often return because the surgery to remove them can also cause them.
