Adhesions are “strings” of connective tissues that are formed as a result of surgery, inflammation or trauma. Any surgical intervention in the pelvis or abdominal cavity leads to adhesions. Protection of a living organism from the spread of purulent-inflammatory processes in the abdominal cavity is the main function of adhesions.
Postoperative adhesions.
Adhesions after surgery are formed due to:
- rough manipulation of the tissue;
- the presence of blood;
- tissue ischemia or hypoxia (this is an insufficient supply of blood and oxygen to tissues);
- drying the tissue during surgery.
Foreign bodies that cause adhesions include particles of adhesions from the doctor’s gloves, suture materials, fibers from tampons or gauze. Adhesions after surgery also form with endometriosis. This is when a small amount of blood containing cells of the uterine mucosa enters the abdominal cavity during menstruation. These cells can be removed with the help of their own immunity, in case of any malfunction they live functioning islands that are secreted into the abdominal cavity. Near these islands spikes are formed.
Adhesions after surgery: symptoms.
Adhesive disease can begin in the form of a gradual or sudden increasing pain, increased bowel movement (peristalsis), which may be accompanied by a rise in temperature, severe vomiting, weakness and a decrease in blood pressure.
Adhesions after surgery: diagnosis.
The presence of scars and various adhesions in the abdominal cavity can be suspected in patients who have suffered a pelvic disease, in women who suffer from endometriosis or have undergone abdominal surgery.
A gynecological examination will suggest the presence of adhesions in the abdominal cavity of a woman with a probability of 75% using ultrasound, but patency of the fallopian tubes will not exclude the presence of these adhesions, which seriously interferes with pregnancy. Promising diagnostics of the adhesive process are methods of magnetic resonance imaging (MRI) or nuclear magnetic resonance (NMR). Thanks to this method, pictures are taken that reflect the general condition of the body and the course of the disease.
Laparoscopy is one of the main diagnostic methods for adhesions, which allows you to assess the severity and treatment of adhesions in the early stages of their manifestation. Three stages of adhesion formation are distinguished:
Stage I, adhesions are around the fallopian tube or ovaries.
Stage II, adhesions are located between the fallopian tube and ovaries.
Stage III, there is a dense blockage of the egg.
Adhesions after surgery: treatment
The main treatment for adhesions after surgery is laparoscopy. Special micromanipulators produce adhesiolysis - this is dissection and removal of the adhesive process. The method of separation of adhesions includes aquadissection, electrosurgery, laser therapy. For the prevention of new formations after laparoscopy, the following methods are used:
- wrapping the ovaries and fallopian tubes with a special polymer absorbable film;
- the introduction of a barrier fluid (povidin, dextran) between the anatomical structures.
Prevention
Among preventive measures, the most important thing is to stop the process of adhesion formation, or to reduce their number, density and distribution in the abdominal cavity, while maintaining the normal healing process.
All methods of prevention can be divided into groups:
1. Surgical methods and their use;
2. The use of drugs and mechanical barriers - the so-called additives;
3. Physiotherapeutic procedures.
Whatever the disease, it is much easier to prevent than to treat it later. Be healthy!