Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
As the body moves, tissues or organs inside are normally able to shift around each other. This is because these tissues have slippery surfaces.
Causes, incidence, and risk factors
Inflammation (swelling), surgery, or injury can cause adhesions to form almost anywhere in the body, including:
Once they form, adhesions can become larger or tighter over time. Symptoms or other problems may occur if the adhesions cause an organ or body part to twist, pull out of position, or be unable to move as well.
The risk of forming adhesions is high after bowel or female organ surgeries. Surgery using a laparascope is less likely than open surgery to cause adhesions.
Other causes of adhesions in the abdomen or pelvis:
Appendicitis, most often when the appendix breaks open (ruptures)
Cancer
Endometriosis
Infections in the abdomen and pelvis
Radiation treatment
Adhesions may form around joints such as the shoulder (see adhesive capsulitis) or ankles, or in ligaments and tendons. This problem may happen:
Symptoms
Adhesions in joints, tendons, or ligaments make it harder to move the joint and may cause pain.
Adhesions in the belly (abdomen) that caused a kink, twist, or pulling may cause a blockage of the intestines. Symptoms include:
Bloating or swelling of your belly
Constipation
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 chronic or long-term pelvic pain.
Signs and tests
Most of the time, the adhesions cannot be seen using x-rays or imaging tests.
Hysterosalpingography may help diagnose adhesions inside the uterus or Fallopian tubes.
X-rays of the abdomen, barium contrast studies, and CT scans may help diagnose 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:
Treatment
Surgery may be done to separate the adhesions. This often allows normal movement of the organ and reduces the symptoms caused by the adhesion. However, the risk for more adhesions increases as the number of surgeries increases.
Depending on the location of the adhesions, at the time of surgery a barrier can be placed to try to reduce the chance of the adhesions returning.
See also: Intestinal obstruction repair
Expectations (prognosis)
The outcome is usually good.
Complications
Depending on the tissues involved, adhesions can cause various disorders.
In the eye, adhesion of the iris to the lens can lead to glaucoma.
In the intestines, adhesions can cause partial or complete bowel obstruction.
Adhesions inside the uterine cavity, called Asherman syndrome, can cause a woman to have irregular menstrual cycles and be unable to get pregnant.
Pelvic adhesions that involve scarring of the fallopian tubes can lead to infertility and reproductive problems.
Abdominal and pelvic adhesions can cause chronic pain.
Calling your health care provider
Call your health care provider if you have:
