Adhesions, General and After Surgery
What are Adhesions?
An adhesion is a band of scar tissue that binds two parts of tissue or organs together. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands.
The tissue develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation. Although adhesions can occur anywhere, the most common locations are within the abdomen, the pelvis, and the heart.
Abdominal adhesions: Abdominal adhesions are a common complication of surgery, occurring in a majority of people who undergo abdominal or pelvic surgery. Abdominal adhesions also occur in a small number of people who have never had surgery.
- Most adhesions are painless and do not cause complications. However, adhesions cause the majority of small bowel obstructions in adults, and are believed to contribute to the development of chronic pelvic pain.
- Adhesions typically begin to form within the first few days after surgery, but they may not produce symptoms for months or even years. As scar tissue begins to restrict motion of the small intestines, passing food through the digestive system becomes progressively more difficult. The bowel may become blocked.
- In extreme cases, adhesions may form fibrous bands around an entire segment of the intestine. This constricts blood flow and can lead to tissue death.
Pelvic adhesions: Pelvic adhesions may involve any organ within the pelvis, such as the uterus, ovaries, Fallopian tubes, or bladder, and usually occur after surgery, such as after C-section or hysterectomy. Pelvic inflammatory disease (PID) results from an infection (usually a sexually transmitted disease) that frequently leads to adhesions in and around the Fallopian tubes. A woman's eggs pass through her Fallopian tubes into her uterus for reproduction. Fallopian adhesions can lead to infertility and increased incidence of ectopic pregnancy in which a fetus develops outside the uterus.
Heart adhesions: Scar tissue may form within the membranes that surround the heart (pericardial sac), thus restricting heart function. Infections, such as rheumatic fever, may lead to adhesions forming on heart valves and leading to decreased heart efficiency.
Adhesions develop as the body attempts to repair itself. This normal response can occur after surgery, infection, trauma, or radiation. Repair cells within the body cannot tell the difference between one organ and another. If an organ undergoes repair and comes into contact with another part of itself, or another organ, scar tissue may form to connect the two surfaces.
Medically Reviewed by a Doctor on 3/1/2016
Eugene Hardin, MD, FACEP, FAAEM
Christopher R Westfall, DO
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