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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Adhesion

Pelvic adhesion; Intraperitoneal adhesion; Intrauterine adhesion

Last reviewed: February 24, 2014.

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

Causes

As the body moves, tissues or organs inside are normally able to shift around each other. This is because these tissues have 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:

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:

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:

  • Bloating or swelling of your belly
  • 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.

Exams and Tests

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

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 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.

When to Contact a Medical Professional

Call 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

References

  1. Munireddy S, Kavalukas SL, Barbul A. Intra-abdominal healing: gastrointestinal tract and adhesions. Surg Clin N Am. 2010;90:1227-1236. [PubMed: 21074038]
  2. Kulaylat MN, Dayton, MT. Surgical complications. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 13.
  3. Paine R. Rehabilitation and therapeutic modalities: a language of exercise and rehabilitation. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 5 section A.

Review Date: 2/24/2014.

Reviewed by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Barrier agents may be effective in reducing the formation of pelvic adhesions but there is no evidence on their direct effects including pregnancy ratesBarrier agents may be effective in reducing the formation of pelvic adhesions but there is no evidence on their direct effects including pregnancy rates
    Sometimes following surgery, adhesions can develop (where two normally separate surfaces join). Pelvic adhesions are most likely to form in association with swelling, endometriosis or surgical trauma. Various materials have been used as 'mechanical' barriers to prevent these adhesions forming. The review of trials assessed the effect of these barriers on pregnancy rates, pelvic pain and adhesion formation after pelvic surgery. The review found the absorbable barrier Interceed reduces adhesion formation. Gore‐Tex is more effective than Interceed but is not absorbable and therefore requires further operation to be removed. There was no evidence of the effectiveness of Seprafilm or Fibrin sheet. More research is needed.
See all (12) ...

Figures

  • Pelvic adhesions.
    Ovarian cyst.

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