Information
Welcome to our section on adhesions. Learn more about adhesions and how they form in the body. We will also discuss symptoms, causes, and treatment options.
Ad·he·sion
Adhesion; internal scar that connects tissues together.
Adhesions: abnormal connective tissue connection
Adhesions form between different organs or tissues in the abdominal cavity. This connective tissue, similar to scar tissue, can stick organs together and restrict their normal movement, which can cause various complications.
Origin and complications
Adhesions often form as part of the body’s normal healing process after surgery, when damaged tissues are repaired by forming scar tissue. After abdominal surgery, about eight out of ten patients develop adhesions. This scar tissue can inadvertently attach to nearby organs or tissues, leading to the formation of adhesions.
Not everyone who develops adhesions will have complications. However, adhesions can certainly lead to several serious problems. Adhesions can cause several digestive problems. For example, they can cause intestinal obstruction, which stops digestion, known as ileus, which may require emergency surgery to free the intestines. Adhesions can also cause chronic abdominal pain, an unexplained and persistent pain. In women, adhesions can also cause problems with getting pregnant. Adhesions can disrupt the normal anatomy of the reproductive organs, leading to problems such as tubal obstruction, decreased mobility of the ovaries, and disruption of embryo implantation. All of these can result in decreased fertility and difficulty getting pregnant for women with adhesions.
Factors That Influence the Chance of Adhesions
Several factors can influence the chance of developing adhesions, such as the type of surgery, the location of the surgery in the abdominal cavity, the duration of the surgery and any inflammation in the abdomen. Genetics and the composition of intestinal bacteria also seem to play a role in the development of adhesions. However, it is important to note that our understanding of adhesion formation is still limited. We are still at the beginning of research into the complex mechanisms that contribute to adhesion formation. Therefore, we continue to conduct extensive research to better understand these factors, with the aim of preventing adhesion formation in the future.
Diagnosis and New Imaging Techniques
Until recently, laparoscopy or a small bowel contrast photo was the only way to detect adhesions. With the contrast photo, this was only possible in the case of a bowel obstruction. However, since 2016, a new imaging technique has been used, the cine MRI scan, which can very accurately visualize adhesions in the abdominal cavity even in the absence of obstruction. If you want to know more about cine MRI or will you soon have a cine MRI and want to see the instructional video, click through to the
Prevention and Treatment
Preventing adhesions is not easy, but avoiding foreign material during surgery, minimizing contamination of the abdominal cavity, and using barriers during surgery may reduce the chance of developing adhesions. Nevertheless, there is no guarantee that adhesions can be completely prevented.
Releasing severe adhesions may lead to risks, such as accidental perforation of the bowel wall, requiring emergency surgery. Furthermore, releasing adhesions does not prevent new adhesions from forming, despite various preventive strategies that are applied.
Future perspective
In short, despite advances in diagnostics and treatment methods, adhesions remain a complex and challenging condition. Much is still unknown about the exact causes and optimal prevention of adhesions. The Dutch Adhesion Group is therefore committed to creating more awareness about adhesions and is conducting numerous studies to gain more insight into this condition. Together we strive for better prevention and treatment of adhesions for all patients.
The video below gives a clear overview of the problems that can be
caused by adhesions
Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis