Intestinal adhesions

Intestinal adhesions are fibrous bands that form between tissues and organs, often as a result of surgery or injury. These bands can cause organs to stick together, leading to various complications, including pain, intestinal obstruction, and infertility in women. Intestinal adhesions are among the most common complications of abdominal surgery, affecting a significant number of patients.

Causes

Intestinal adhesions can develop after abdominal or pelvic surgery, which is the most common cause. Surgeries that involve the intestines, such as appendectomy, colectomy, or gynecological surgery, are particularly likely to lead to adhesions. However, they can also form after inflammation from conditions like peritonitis, endometriosis, or Crohn's disease. Trauma to the abdomen can also result in adhesions.

Symptoms

The symptoms of intestinal adhesions can vary widely, from being asymptomatic to causing severe abdominal pain and discomfort. The most common symptom is chronic abdominal pain. In cases where the adhesions lead to a partial or complete intestinal obstruction, symptoms may include nausea, vomiting, inability to pass gas or stool, and severe abdominal pain. If left untreated, intestinal obstruction can be life-threatening.

Diagnosis

Diagnosing intestinal adhesions can be challenging, as they do not show up on standard imaging tests like X-rays or ultrasound. A CT scan or MRI can sometimes identify obstructions or abnormalities suggestive of adhesions. In many cases, a definitive diagnosis is made during a surgical procedure called laparoscopy, where a camera is inserted into the abdomen to directly visualize the adhesions.

Treatment

Treatment for intestinal adhesions depends on the severity of the symptoms. In mild cases, treatment may not be necessary. For more severe symptoms, especially those involving intestinal obstruction, surgery may be required to remove the adhesions. However, surgery can itself lead to the formation of new adhesions, making the decision to operate a complex one. In some cases, a conservative approach with pain management and monitoring may be preferred.

Prevention

Preventing the formation of intestinal adhesions is a key focus during and after surgery. Techniques such as using minimally invasive surgical methods like laparoscopy, applying adhesion barriers, and reducing surgical handling of the tissues can help minimize the risk of adhesion formation.

Complications

Complications from intestinal adhesions can be serious and include chronic pain, intestinal obstruction, and infertility. Intestinal obstruction can lead to sepsis and death if not treated promptly. Chronic pain can significantly impact the quality of life and may require ongoing management.