Postoperative adhesions

Many people had to endure various operations. However, not everyone knows what adhesions after surgery are.

Postoperative adhesions are formations of connective tissue in the abdominal or pelvic region that connect internal organs. They act as a defense and limit the focus of inflammation. Adhesions after surgery lead to disruption of the internal organs.

In the normal state, the internal organs are covered with a slippery membrane, which does not allow them to stick to each other. Spike appears after the operation. Clinical manifestations depend on the number and location of adhesions. Treatment can only be done surgically.

Causes

Adhesions form after surgery as a response to an inflammatory response. They connect adjacent organs or intestinal loops.

The main reasons for the appearance of strands are:

• surgical interventions;
• inflammation of the appendix and appendectomy;
• abortion;
• hemorrhage in the abdominal cavity;
• endometriosis;
• inflammatory diseases.

Surgery is the main cause, but there are other risk factors:

1. Abdominal bruises. As a result, hemorrhage may occur.
2. abdominal obesity. Excess adipose tissue forms a greater omentum that closes the intestinal loops. The loose tissue of the omentum is especially sensitive to the appearance of strands.
3. Congenital anomalies of the abdominal organs.
4. The ingress of chemicals. This usually happens at the time of the operation, particles of gauze, iodine or other chemicals get inside. Because of this, adhesions may also appear after surgery.

Postoperative adhesions are also formed due to the ingress of foreign objects.

Why are spikes dangerous?

Normally, the organs in the abdominal and pelvic region are mobile. Intestinal loops can move during digestion. During pregnancy, an enlarged uterus does not adversely affect the bladder.

The resulting scars disrupt the mobility of internal organs. Adhesive disease is dangerous for the development of intestinal obstruction. For women, this can lead to infertility. In some cases, adhesions may not cause discomfort to the patient. However, most often the patient is concerned about the pain syndrome.

Clinical picture

The duration of the formation of adhesions depends on the affected organ. Usually the patient is worried about pain in the area of ​​the surgical scar.

The most common symptoms are:

• nausea, vomiting;
• diarrhea or constipation;
• pain on palpation in the suture area;
• increase in body temperature;
• dyspnea;
• hyperemia in the area of ​​the scar.

At first, there are no symptoms. However, with the progression of the process, pulling pains appear. In some cases, pain occurs when you take a deep breath. If adhesions develop in the pelvic region, then pain in a woman can be observed during intercourse.

Very often, the adhesive process appears between adjacent organs. A cause for concern is paroxysmal pain, which is not stopped by taking antispasmodic drugs. After some time, after the onset of symptoms, the person becomes irritable. Three forms of pathology are officially distinguished:

1. Acute form - characterized by severe pain. Shortness of breath increases, body temperature rises. When you try to palpate the area, a sharp pain appears. Leads to acute intestinal obstruction and renal failure.
2. Chronic form - if the pathology appeared in the pelvic area, then the symptoms are similar to premenstrual syndrome. There may be a violation of the bowel and bladder. Pain syndrome appears with a change in body position and sexual contact.
3. Intermittent form - characterized by symptoms in the gastrointestinal tract. Constipation is replaced by diarrhea and vice versa.

In addition to pain, headaches and general malaise appear.

Diagnostic methods

If symptoms appear, the patient should consult a specialist. First, an examination and collection of an anamnesis of the patient is carried out. Diagnosis of the disease should be comprehensive.

Analyzes

First of all, the patient needs to be tested.

1. Complete blood count - prescribed for any disease. The analysis can show the presence of inflammatory processes, as well as the general condition of the body. With adhesive disease, there is leukocytosis, which indicates an inflammatory process in the body. There is also anemia.
2. Biochemical blood test - can tell about the work of internal organs, especially the liver and kidneys. There are abnormalities: an increased level of urea, a low level of hemoglobin and C-reactive protein (with acute inflammation).

If bowel obstruction is suspected, a stool test may be required. Additional studies may include a blood test for hormones and an analysis of seminal fluid.

Instrumental diagnostic methods

The main diagnostic methods are instrumental studies. They are more informative than analyzes. If adhesions are suspected after surgery, the following studies are prescribed:

• Ultrasound - the study shows the presence of adhesions;
• CT is the most informative method;
• radiography with a contrast agent - before the procedure, you need to drink a special solution, which, when taken, shows disturbances in the functioning of the intestines and other complications;
• laparoscopy - a small incision is made in the abdominal cavity, and then a tube with a camera and lighting is placed. This allows you to diagnose from the inside.

After conducting instrumental diagnostics, the doctor may prescribe treatment or refer you for an additional examination.

Differential Diagnosis

Adhesive disease can be easily confused with diseases of the internal organs, since many clinical symptoms are similar. You need to know how to distinguish the adhesive process from another disease:

• pinched hernia - characterized by protrusion, pain and tension in the affected area;
• acute pancreatitis and cholecystitis - indomitable nausea and vomiting, fever, shingles;
• peptic ulcer of the gastrointestinal tract - paroxysmal pain in the abdominal region;
• acute appendicitis - pain in the right iliac region. High body temperature and an increase in white blood cells;
• torsion of an ovarian cyst - paroxysmal pain in the lower abdomen.

Such a diagnosis is carried out if adhesions are suspected. Diagnosis should be comprehensive and after the diagnosis is clarified, treatment is prescribed.

Treatment

You need to know how to treat adhesions after surgery. If they have just begun to form, then they can be easily eliminated with timely treatment. Over time, the adhesions become coarser and more like scars or welts.

Surgery

In chronic forms of adhesive disease, surgical intervention is necessary. Under general anesthesia, adhesions are removed.

1. Laparotomy (operation through an incision in the abdominal wall) and laparoscopy (operation through punctures).
2. Excision of adhesions with a laser or an electric knife.

During the operation, adhesions are eliminated, but this does not guarantee the exclusion of relapses. The more surgical operations are performed, the higher the likelihood of developing adhesive disease.

Medical treatment

Medicines may be used in the early stages. Enzyme therapy is carried out for the introduction of split enzymes into the body, administered intramuscularly. Anti-inflammatory ointments are well suited for topical application.

Physiotherapy

Especially physiotherapy is effective in the adhesive process in the pelvic area. The following procedures are carried out:

• ozokerite and paraffin applications;
• electrophoresis with painkillers;
• laser therapy;
• magnetotherapy;
• ultrasound treatment;
• massage;
• hirudotherapy.

Physiotherapy can also be used in advanced stages of the disease. They contribute to the elimination of the inflammatory process and pain syndrome.

Prevention

To avoid the development of adhesions, the patient is required to follow the recommendations that the doctor gave after the operation. A couple of days after the operation, the patient needs to restore motor activity. Even slight movements act on the internal organs as a massage, which does not allow them to stick together. The combination of physical activity and special massage will help to avoid the formation of adhesions after surgery. It is easier to carry out prevention, then to wonder how to remove adhesions after surgery.