Abdominal Adhesions: What They Are, Causes and Complications

Adhesions are bands of tissue resembling a scar that connect organs and tissues that normally slide freely against one another. Below are the definition, the mechanism of formation, symptoms, and complications that make adhesions more than an incidental finding.

What adhesions and the adhesive process are

An adhesion is a band of tissue resembling scar tissue. Normally, internal tissues and organs have smooth, sliding surfaces and move easily with body movements. Adhesions disrupt this property: they stick surfaces together. In the abdominal cavity, adhesions can connect loops of intestine to each other, to neighboring organs, or to the abdominal wall, and can also pull on sections of the intestine, displacing them from their usual position.

The term "adhesive process" describes the very fact that such unions form and are present. Adhesions can occur in any area of the body, but they form especially often after abdominal surgery. An important detail: having adhesions and having a disease are not the same thing; some adhesions cause no problems at all.

Why adhesions form

Adhesions often form after abdominal surgery — in virtually everyone who has undergone such an operation. They stick tissues together and can displace sections of the intestine from their usual position.

Adhesions are the most common cause of intestinal obstruction: they are listed first among the causes, followed by hernias, tumors, and certain medications.

What symptoms may occur

Adhesions without compression of the intestine usually cause no symptoms. Symptoms appear when adhesions partially or completely block the intestinal lumen:

• severe pain or cramping abdominal pain;
• vomiting;
• abdominal bloating;
• absence of passing gas;
• constipation;

In intestinal obstruction, loud bowel sounds and abdominal distension are added to this set. These signs are nonspecific: the same symptoms are described in obstruction of other origins, so it is impossible to distinguish one from the other based on sensations alone.

How adhesions are detected

There is no separate examination that detects adhesions: they are usually found during surgery performed for another reason. Reference materials on the topic mention CT enterography, barium enema radiography, laparoscopy, and hysterosalpingography. Some adhesions disappear on their own over time.

What complications are possible, including intestinal obstruction

The main complication is intestinal obstruction: a condition in which food or stool cannot move through the intestine. Obstruction can be partial or complete. Complete obstruction is life-threatening: care is provided immediately, and surgery is often required. The second described consequence is infertility in women: adhesions can prevent a fertilized egg from reaching the uterus.

When to see a doctor urgently

A routine reason to talk to a doctor is having had abdominal surgery and having questions about possible adhesions. An emergency reason is a picture of obstruction.

Adhesions alone are not a reason to call an ambulance. 103 or 112 — if severe or cramping abdominal pain, vomiting, bloating and abdominal distension appear, gas does not pass, stool is retained, and loud bowel sounds are heard: these are signs of possible complete intestinal obstruction, which is life-threatening.

A doctor assesses the condition.

This material is for reference: it describes the general picture and does not replace consultation with a doctor who sees the individual person.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer