All surgery causes some scar tissue as part of the healing
process. It's the same on the inside as it is on the
outside. You may have heard about adhesions.
Adhesions are filmy bands of scar tissue that may occur
within the abdomen. They can develop in response to prior
abdominal trauma or infection, but most often occur after
abdominal surgery - often many years later. Adhesions
themselves, like any form of scarring, are not harmful. In
fact, most adhesions cause no symptoms at all.
The most serious complication is intestinal obstruction.
Sometimes, adhesive bands will connect between two loops of
small intestine. This may cause a kink to form in the small
intestine and lead to a bowel blockage. Just like bending a
garden hose stops the flow of water, a kink in the small
intestine can block the flow of food in the digestive tract.
Symptoms of a blockage of the small intestine would include
crampy abdominal pain, distention of the abdomen,
constipation, and vomiting. Neither x-ray studies nor scope
tests can see adhesions, but x-rays can see the dilated
loops of small intestine above the blockage. A blocked
intestine is a medical emergency and requires
hospitalization. Without treatment, severe dehydration and
electrolyte imbalances occur. Eventually, the blocked
intestine dies and develops gangrene and peritionitis which
can be fatal. Minor episodes can be treated by withholding
food for several days and inserting a tube down though the
nose and into the stomach (NG or nasogastric tube) to pump
out the stomach contents. If the blockage persists,
exploratory surgery is needed to release the adhesive bands.
The other common complication of abdominal adhesions is
pain. Since adhesions can develop between surfaces inside
the abdomen which are not normally connected, they can tug
and pull which may be felt as persistent adominal pain. As
mentioned above, neither x-ray studies nor scope tests can
see adhesions, so the diagnosis is difficult. In severe
cases, surgery may be needed to make the diagnosis and lyse
(cut) the fibrous bands. Unfortunately, since any abdominal
surgery can lead to future adhesions, they are often
recurrent.
Updated 5/2002
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