Helen Dynda wrote:
> > Abdominal Adhesions > > * What is it? * Prevention > * Symptoms * Treatment > * What your doctor looks for * When to call your doctor > * Diagnosis * Prognosis > * Expected duration * Additional info > > What is it? > > Abdominal adhesions are bands of fibrous scar tissue that form on the > abdominal organs, causing the organs to stick to one another or to the > abdominal wall. The fibrous scarring of adhesions may be due to the > after-effects of peritonitis (an infection of the membrane covering > the abdominal organs), or it may follow the mechanical injury of > serious abdominal trauma. However, in patients living in developed > countries, adhesions most commonly develop after abdominal surgical > procedures, where organs are handled by the surgical team and > temporarily shifted from their normal positions. > > In most patients, post-surgical adhesions are inconsequential and > produce no health problems. Their existence is merely an incidental > finding on autopsy after a patient's death. In about 3% of > post-surgical patients, however, fibrous bands of adhesions interfere > with the normal passage of intestinal contents, causing either a full > or partial intestinal obstruction. In even fewer cases, a portion of > the bowel strangulates -twists around a band of adhesions. This > strangulation cuts off the normal blood supply to the twisted bowel, > and the affected portion of bowel begins to die. When this happens, > the patient must be taken to surgery immediately. > > Adhesions are fairly rare in patients who have never had abdominal > surgery. Among those who have had only one abdominal surgical > procedure, adhesions occur postoperatively in 67%-81% of cases. Among > those who have had multiple abdominal surgeries, at least 93% develop > adhesions. > > Symptoms > > In most patients, abdominal adhesions produce no symptoms. However, if > adhesions cause partial, transient intestinal obstruction, the patient > may have intermittent bouts of crampy abdominal pain. > > When more significant intestinal obstruction develops, the patient may > have the following symptoms: > > ** Severe, crampy abdominal pain - If the obstruction is in the small > intestine, pain may localize around or above the navel. If the > obstruction involves the large intestine, abdominal pain may > concentrate below the navel. > > ** Vomiting - This may produce either clear stomach juices, or > foul-smelling intestinal juices. > > ** Diarrhea - This is most likely to occur early in the obstruction > process. > > ** Absent or infrequent bowel movements > > ** Signs of dehydration - These include dry skin, dry mouth and > tongue, severe thirst, and infrequent urination. > > When strangulation occurs, the patient looks very ill. They have > severe, constant abdominal pain, together with other symptoms of > obstruction, plus a fever and a rapid heartbeat. > > What your doctor looks for > > Your doctor will look for symptoms of obstruction or strangulation. He > or she will also ask you about any surgical procedures you've had, or > any episodes of peritonitis or severe abdominal trauma. > > Diagnosis > > Your doctor will suspect the diagnosis of intestinal obstruction or > strangulation based on your symptoms and your surgical history, > together with the results of your physical examination. In addition to > the standard physical exam, with special attention to your abdomen, > your doctor will also perform a rectal examination and (in women) a > pelvic exam. To find further evidence for the diagnosis, your doctor > will order blood tests and x-rays of your chest and abdomen. In some > patients with suspected intestinal obstruction or strangulation, the > diagnosis is only confirmed at the time of abdominal surgery. > > Expected duration > > Abdominal adhesions are permanent, unless the patient undergoes > adhesiolysis (a surgical procedure to break up adhesions). > > Prevention > > Patients cannot prevent adhesions. If you are undergoing abdominal > surgery, your surgeon can minimize the risk for adhesions by using a > gentle surgical technique, powder-free gloves, and (in some cases) > FDA-approved absorbable "adhesion barriers" to protect tissue. > > Treatment > > When adhesions produce intestinal strangulation or significant > intestinal obstruction, abdominal surgery is required. > > When to call your doctor > > Call your doctor whenever you have severe abdominal pain, especially > if you also have a fever, nausea and vomiting, or infrequent bowel > movements. > > Prognosis > > Once abdominal adhesions have formed, even adhesiolysis surgery may > not cure the problem. For example, when surgery is performed to remove > an intestinal obstruction caused by adhesions, adhesions re-form and > create a new obstruction in 11%-21% of cases. > > - - - - - - - - > > NOTE: If for some reason this article is difficult to read, please go > to the following Url.....Enter: "Adhesions" in the upper left-hand > corner and click: "Go".....Then click: "Abdominal Adhesions." > > http://www.intelihealth.com/IH/ihtIH >
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