An adhesion is a scar tissue in a form of band which develops after surgery or inflammation and which connects parts of different tissues. The tissues that are connected are supposed to be separated and their artificial connection caused by adhesions may lead to certain complications. Apart from forming after surgery and during inflammatory processes adhesion may occur after radiation therapy and trauma. Predilection places for adhesions include the abdominal cavity, pelvis and heart.
Abdominal adhesions typically occur after abdominal surgeries. They affect almost 93% of all patients. One may not even know he/ she is suffering from adhesion since they do not have to cause any symptoms. On the other side adhesions may lead to certain complications such as pain, intestinal obstruction, constriction of blood flow in intestine etc. The first symptoms occur months or even years after the surgery.
Pelvic adhesions may affect each and every organ in the pelvis. They develop as a consequence of infection or after different surgical procedures in the pelvis. Some adhesions are asymptomatic while others may cause certain symptoms such as chronic pelvic pain. Fallopian adhesions may be a cause of infertility.
The heart adhesions affect the pericardium and may restrict heart function. The most common causes of pericardial adhesions are infections, particularly rheumatic fever.
Symptoms of Adhesions
In majority of patients adhesions are asymptomatic.
The symptoms originate from abnormal function of organs affected by adhesions. They vary a lot and basically depend on which organ has been affected. Pain may be one of the symptoms and is related to nerve irritation. For example, adhesion above the liver can induce pain with deep breathing, intestinal adhesion may cause obstruction and consequent pain and pericardial adhesion are responsible for chest pain.
Diagnosis of Adhesions
Diagnosis can be easily set after laparoscopic examination. During this procedure all internal organs are well-visualized and adhesions can be perfectly noticed. Laparoscopy is an excellent procedure since it can provide with instant removal of adhesions once they have been identified.CT scan may be of additional help in visualization of the extent of adhesions. And finally, most adhesions are found during surgery which is performed to fix the damage caused by very adhesions.
Treatment for Adhesions
Treatment for adhesions basically depends on the location, extent and symptoms caused by adhesions. Sometimes doctors only treat symptoms and if conservative therapy is not effective enough patients eventually undergo surgical repair.
Abdominal adhesions may be fixed by laparoscopy and laparotomy. In laparoscopy after visualization of adhesions by a camera the doctor performs adhesiolysis. In laparotomy, a large incision is made and this provides with direct approach to adhesions which are then resected. Patients may suffer from recurrent adhesions since any cutting may result in repeated scarring.