Adhesions

Adhesions

Adhesions are bands of scar tissue that form between tissues and organs, often as a result of surgery, inflammation, or injury. These fibrous bands can cause tissues and organs to stick together, which can lead to complications such as pain, obstruction, or impaired function.

Pathophysiology

Adhesions form as part of the body's natural healing process. When tissues are damaged, the body initiates a repair process that involves the formation of scar tissue. In some cases, this scar tissue extends beyond the site of injury, forming adhesions that connect separate tissues or organs. This can occur in various parts of the body, including the abdomen, pelvis, and around the heart or lungs.

The formation of adhesions is influenced by several factors, including the extent of tissue damage, the presence of infection or inflammation, and individual patient factors such as genetic predisposition.

Clinical Manifestations

Adhesions can be asymptomatic or cause a range of symptoms depending on their location and severity. Common symptoms include:

• Abdominal pain: Adhesions in the abdomen can cause chronic pain or discomfort.
• Bowel obstruction: Adhesions can lead to partial or complete obstruction of the intestines, resulting in symptoms such as nausea, vomiting, and abdominal distension.
• Infertility: Pelvic adhesions can affect the reproductive organs, leading to infertility in women.
• Restricted movement: Adhesions around joints or muscles can limit mobility and cause pain.

Diagnosis

Diagnosing adhesions can be challenging, as they are not visible on standard imaging tests such as X-rays or ultrasounds. However, advanced imaging techniques like MRI or CT scans may suggest their presence. In many cases, adhesions are diagnosed during surgical procedures, such as laparoscopy, when they are directly visualized.

Treatment

Treatment of adhesions depends on the severity of symptoms and the impact on the patient's quality of life. Options include:

• Conservative management: For mild symptoms, pain management and lifestyle modifications may be sufficient.
• Surgical intervention: In cases of severe symptoms or complications like bowel obstruction, surgery may be necessary to remove or separate adhesions. However, surgery itself can lead to the formation of new adhesions.
• Adhesion barriers: During surgery, adhesion barriers may be used to reduce the risk of new adhesions forming.

Prevention

Preventing adhesions involves minimizing tissue trauma during surgery, using minimally invasive techniques when possible, and employing adhesion barriers. Additionally, managing inflammation and infection promptly can reduce the risk of adhesion formation.

Prognosis

The prognosis for patients with adhesions varies. Some individuals may experience significant relief from symptoms following treatment, while others may have recurrent issues. The risk of adhesion-related complications can persist long-term, necessitating ongoing monitoring and management.

Also see

• Scar tissue
• Bowel obstruction
• Laparoscopy
• Infertility

Classification
External resources