Adhesion

Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.

Causes

With movement of the body, internal organs such as the bowel or uterus are normally able to shift and to slide past each other. This is because these tissues and organs in the abdominal cavity have smooth, slippery surfaces. Inflammation (swelling), surgery, or injury can cause adhesions to form and prevent this movement. Adhesions can occur almost anywhere in the body, including:

• Joints, such as the shoulder
• Eyes
• Inside the abdomen or pelvis

Adhesions can become larger or tighter over time. Problems may occur if the adhesions cause an organ or body part to:

• Twist
• Pull out of position
• Be unable to move normally

The risk of forming adhesions is high after bowel or female organ surgeries. Surgery using a laparoscope is less likely to cause adhesions than open surgery.

Other causes of adhesions in the abdomen or pelvis include:

• Appendicitis, most often when the appendix breaks open (ruptures)

  Appendicitis

  Appendicitis is a condition in which your appendix gets inflamed. The appendix is a small pouch attached to the end of the large intestine.

  

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• Cancer
• Endometriosis

  Endometriosis

  Endometriosis occurs when cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy vaginal bleeding,...

  

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• Infections in the abdomen and pelvis, such as appendicitis or fallopian tube infection
• Radiation treatment

Adhesions around the joints may occur:

• After surgery or trauma
• With certain types of arthritis
• With overuse of a joint or tendon

Symptoms

Adhesions in joints, tendons, or ligaments make it harder to move the joint. They may also cause pain.

Adhesions in the belly (abdomen) may cause a blockage of the intestines. Symptoms include:

Blockage of the intestines

Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.

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• Bloating or swelling of your belly
• Constipation

  Constipation

  Constipation in infants and children means they have hard stools or have problems passing stools. A child may have pain while passing stools or may ...

  

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• Nausea and vomiting
• No longer being able to pass gas
• Pain in the belly that is severe and crampy

Adhesions in the pelvis may cause long-term (chronic) pelvic pain.

Exams and Tests

Most of the time, the adhesions cannot be seen using x-rays or imaging tests.

• Hysterosalpingography may help detect adhesions inside the uterus or fallopian tubes.

  Hysterosalpingography

  Hysterosalpingography is a special x-ray using dye to look at the womb (uterus) and fallopian tubes.

  

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• X-rays of the abdomen, barium contrast studies, and CT scans may help detect a blockage of the intestines caused by adhesions.

Endoscopy (a way of looking inside the body using a flexible tube that has a small camera on the end) may help diagnose adhesions:

• Hysteroscopy looks inside the uterus
• Laparoscopy looks inside the abdomen and pelvis

  Laparoscopy

  Diagnostic laparoscopy is a procedure that allows your health care provider to look directly at the contents of the abdomen or pelvis.

  

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Treatment

Surgery may be done to separate the adhesions. This can let the organ regain normal movement and reduce symptoms. However, the risk for more adhesions goes up with more surgeries.

Depending on the location of the adhesions, a barrier may be placed at the time of surgery to help reduce the chance of the adhesions returning.

Outlook (Prognosis)

The outcome is good in most cases.

Possible Complications

Adhesions can cause various disorders, depending on the tissues affected.

• In the eye, adhesion of the iris to the lens can lead to glaucoma.

  Glaucoma

  Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain. Most often, optic nerve da...

  

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• In the intestines, adhesions can cause partial or complete bowel obstruction.

  Bowel obstruction

  Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.

  

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• Adhesions inside the uterine cavity can cause a condition called Asherman syndrome. This can cause a woman to have irregular menstrual cycles and be unable to get pregnant.

  Asherman syndrome

  Asherman syndrome is the formation of scar tissue in the uterine cavity. The problem most often develops after uterine surgery.

  

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• Pelvic adhesions that involve scarring of the fallopian tubes can lead to infertility and reproductive problems.
• Abdominal and pelvic adhesions can cause chronic pain.

When to Contact a Medical Professional

Contact your health care provider if you have:

• Abdominal pain
• An inability to pass gas
• Nausea and vomiting that do not go away
• Pain in the belly that is severe and crampy