What Are Abdominal Adhesions? Causes, Symptoms and Complications

What are abdominal adhesions?

Abdominal adhesions are bands of scar-like tissue that form inside the abdomen and connect two or more organs or connect organs to the abdominal wall. Normally, organ surfaces are smooth and can move freely as the body moves, whereas adhesions make these surfaces stick together. Adhesions can pull on the intestines, change their position, or compress them. [1] [2]

Abdominal surgery is the most common cause of adhesions. They can develop after open or laparoscopic surgery, but they can also result from inflammation or infection inside the abdomen, certain inflammatory conditions, radiation therapy, and, in some cases, conditions present from birth. Symptoms and complications from adhesions can begin long after surgery, even many years later. [1]

Do adhesions cause symptoms?

Many people with abdominal adhesions have no symptoms or complications. When symptoms occur, chronic abdominal pain is one possible symptom. The most important complication occurs when adhesions cause a partial or complete intestinal obstruction, preventing food, fluids, gas, or stool from moving normally through the intestine. [1] [2]

Signs of intestinal obstruction may include abdominal pain or cramping, bloating, constipation, inability to pass gas, nausea, or vomiting. If blood flow to part of the intestine is cut off or inflammation of the abdominal lining develops, fever or a fast heart rate may occur, and the obstruction can become life-threatening. [1]

How are adhesions diagnosed?

There is usually no simple imaging test that can reliably show the adhesions themselves. Doctors use the medical history and physical examination and may order blood tests or imaging to rule out other causes or identify whether an intestinal obstruction is present and determine its location and severity. CT scans, X-rays, and certain contrast studies can help evaluate intestinal obstruction. [1] [2]

In some cases, surgery is the way adhesions can be directly seen, and they may be released during the procedure when appropriate. Therefore, abdominal pain after previous surgery does not necessarily mean that adhesions are the cause; other conditions can also produce abdominal pain and require assessment. [1] [2]

When is urgent treatment needed?

If adhesions do not cause symptoms or complications, they generally do not require treatment. When they cause symptoms or complications, selected patients may undergo surgery to release the adhesions, although surgery itself can lead to new adhesions. [1]

Abdominal pain accompanied by bloating or vomiting and an inability to pass gas or stool, especially when the pain is severe or there is fever or overall deterioration, requires immediate medical assessment because intestinal obstruction may be present; do not wait for symptoms to settle at home. [1]

For further reading: Abdominal Adhesions: Causes, Symptoms, and Complications article (Arabic article).

What are abdominal adhesions?