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Congenital Peritoneal Adhesions
Congen Peritoneal Adhesions

Presentation

[…] if the condition was present at the time of inpatient admission. [icd.codes]

Congenital Caecal Band Presenting as Appendicitis. The Internet Journal of Surgery. 2008 Volume 21 Number 2. Abstract Congenital bands are extremely rare and often present in childhood with symptoms of bowel obstruction. [ispub.com]

This book presents the current knowledge on the aetiopathogenesis of adhesion formation as well as the available methods for their prevention and control. [books.google.com]

Bowel resection may be necessary if the membrane cannot be stripped atraumatically or if obvious gangrene of the bowel is present. [ijcasereportsandimages.com]

In the present case, plain abdominal X-ray revealed air-fluid levels located on the left side of the abdomen, which remained unaltered in a subsequent image after 2 hours. [saudijgastro.com]

Entire Body System

  • Pain

    […] of abdominal pain during exercise. [bjsm.bmj.com]

    Having had pelvic pain and 'contracture' like abdo pains. An ultrasound said poss polyp. … Mr Stephen Not rated yet Im 44 and have a pain in my right lower stomach and at times round my back. The pain is sharp and comes and goes. [abdopain.com]

    Symptoms of ARD may include: chronic pain infertility bowel obstruction and an inability to pass gas urinary bladder dysfunction pain and difficulty having a bowel movement pain on movement such as walking, sitting or lying in certain positions emotional [betterhealth.vic.gov.au]

    Despite the well-known surgical wisdom that "operating purely to cure pain only brings pain," chronic abdominal pain can be a relative indication for adhesiolysis. [emedicine.medscape.com]

    Laparoscopic surgery lysis of adhesions is commonly used to resolve small bowel obstruction and occasionally to relieve abdominal pain syndromes. [newportlaparoscopy.net]

  • Surgical Procedure

    The technical key steps of the surgical procedure are presented in a step by step way: abdominal exploration, exposure, dissection, lavage/drainage, closure. [websurg.com]

    The da Vinci System is a robotic surgical platform designed to enable complex procedures of all types to be performed. [newportlaparoscopy.net]

    Abdominal adhesions [ edit ] Abdominal adhesions (or intra-abdominal adhesions) are most commonly caused by abdominal surgical procedures. [en.wikipedia.org]

    Adhesions are a major complication of many common surgical procedures and may occur in 55% to more than 90% of patients, depending on the type of surgery. [medical-dictionary.thefreedictionary.com]

    Open adhesiolysis As adhesions are likely to form after certain surgical procedures, open adhesiolysis may not be worthwhile, except to remedy serious problems such as bowel obstruction. [betterhealth.vic.gov.au]

  • Asymptomatic

    Most adhesions are asymptomatic; the most common complication is bowel obstruction (partial ... Subscribe to Access Full Content Sign Up for a 10-Day Free Trial Sign up for a 10-day FREE Trial now and receive full access to all content. [5minuteconsult.com]

    Although many adhesions are asymptomatic, small bowel obstruction (SBO), infertility, and chronic pain are the most common complications. Epidemiology Incidence True incidence is difficult to determine because some adhesions are asymptomatic. [unboundmedicine.com]

    All paraduodenal hernias must be repaired, including those that are asymptomatic. [15] Release of adhesions in congenital bands and the retroperitonealization of vessel leading to obstruction is recommended. [ijcasereportsandimages.com]

    New complaints during exertion in an experienced and previously asymptomatic athlete, the absence of triggering factors such as trauma or dietary excesses, a change in the pattern, duration, or severity of pain, or the persistence of symptoms after exertion [bjsm.bmj.com]

    An annular pancreas can be asymptomatic or can cause external compression of second portion of the duodenum, which creates a partial or compete obstruction. [laparoscopyhospital.com]

  • Severe Pain

    The patient is often elderly with numerous comorbidities. [ 10 ] Pseudo-obstruction presents like a large bowel obstruction but the other medical history may indicate the true nature. [ 5 ] Severe pain and tenderness suggest ischaemia or perforation. [patient.info]

    […] been suffering with severe stomach and back pain for the last 4 months following a number of major stomach operations. [abdopain.com]

    We present the case of an athlete who had severe and recurrent abdominal pain during physical exertion. [bjsm.bmj.com]

    Severe pain early in the patient’s course is concerning for closed-loop obstruction with risk for infarction and perforation. [clinicaladvisor.com]

  • Neonatal Intestinal Obstruction

    […] ileus NOS ( P76.0 ) neonatal intestinal obstructions classifiable to P76.- obstruction of duodenum ( K31.5 ) postprocedural intestinal obstruction ( K91.3- ) stenosis of anus or rectum ( K62.4 ) Paralytic ileus and intestinal obstruction without hernia [icd10data.com]

    Congenital gastrointestinal malformations can cause neonatal intestinal obstruction. Another cause of meconium ileus is cystic fibrosis. [patient.info]

Gastrointestinal

  • Abdominal Distension

    Abdominal distension will be apparent. It may be worth measuring abdominal girth to monitor progress. Massive peristalsis may even by visible. Distended bowel is very resonant on percussion. [patient.info]

    Symptoms of significant intestinal obstruction due to adhesions include: severe abdominal pain and cramping nausea and vomiting abdominal distension (swelling) constipation and the inability to pass gas symptoms of dehydration. [medical-dictionary.thefreedictionary.com]

    The patient had no history abdominal surgery. On physical examination abdominal distension was noted with an ill-defined nontender mass in lower abdomen. [casereports.in]

    History Prior abdominal surgery History of abdominal infection or pelvic inflammatory disease Bowel complaints: Crampy abdominal pain Nausea, vomiting Minimal to no flatus Loud bowel sounds (borborygmi) Abdominal distension If involving a pelvic structure [unboundmedicine.com]

    […] obstructions cause more nausea and vomiting but less abdominal distension. [clinicaladvisor.com]

  • Acute Abdomen

    Abdominal masses may possibly be felt but even a large mass may be missed in a grossly distended abdomen. If strangulation or perforation occurs there will be features of an acute abdomen with peritonism. Check hernial orifices. [patient.info]

    […] cell腺房細胞 acoustic shadow音響陰影 acute abdomen急性腹症 acute appendicitis急性虫垂炎 acute cholangitis (cholangitis acuta)急性胆管炎 acute cholecystitis (cholecystitis acuta)急性胆嚢炎 acute diarrhea急性下痢 acute duodenitis急性十二指腸炎 acute gastric dilatation急性胃拡張 acute hepatic insufficiency [tokyo-med.ac.jp]

    “Cope's early diagnosis of the acute abdomen”. 2010. Alvarez-Downing, M, Klaasen, Z, Orringer, R, Gilder, M, Tarantino, D, Chamberlain, R. “Incidence of small bowel obstruction after laparoscopic and open colon resection”. [clinicaladvisor.com]

  • Abdominal Tenderness

    abdominal tenderness R10815Periumbilic abdominal tenderness R10816Epigastric abdominal tenderness R10817Generalized abdominal tenderness R10819Abdominal tenderness, unspecified site R10821Right upper quadrant rebound abdominal tenderness R10822Left upper [cms.gov]

    There was no history of any abdominal surgery in the past. On examination, the patient was afebrile with a pulse rate of 92/min and blood pressure 100/64 mmHg. Abdominal examination showed generalized abdominal tenderness with mild guarding. [jmgims.co.in]

    complaints may include: Lower abdominal pain (either chronic or acute) Infertility Nausea/vomiting Physical Exam Vital sign abnormalities (evidence of ischemia, dehydration, or infection) Fever Tachycardia Diffuse abdominal tenderness Peritoneal signs [unboundmedicine.com]

    /absent as the bowel distends Abdominal tenderness: mild diffuse tenderness is common, but peritoneal findings raise concern for strangulation Hernias (abdominal wall, inguinal, or femoral): note that if hernia contents are soft and reducible, the hernia [clinicaladvisor.com]

  • Chronic Abdominal Pain

    The results with this technique have been favorable both for resolution of obstructive symptoms and in providing symptomatic relief in patients with chronic abdominal pain syndromes. [newportlaparoscopy.net]

    Another valid, albeit less definitive, sequela of intra-abdominal adhesions is chronic abdominal pain. [emedicine.medscape.com]

    A person with ARD will usually experience chronic abdominal pain. Typical adhesions form within the first few days after surgery, but symptoms can last for months or even years. [betterhealth.vic.gov.au]

  • Abdominal Cramps

    cramping and other symptoms Treatment for colonic diseases varies greatly depending on the disease and its severity. [icdlist.com]

    Partial or off-and-on intestinal obstruction due to adhesions may result in intermittent periods of painful abdominal cramping and other symptoms, including diarrhea. [medical-dictionary.thefreedictionary.com]

    Mechanical stimulation of the intestinal mucosa during running may result in a release of vasoactive intestinal peptide (VIP) 17, 18 and prostaglandins, 9 which promote colonic contraction and could cause abdominal cramps and secretory diarrhoea. [bjsm.bmj.com]

Cardiovascular

  • Hypotension

    Examination Look for signs of dehydration such as poor peripheral perfusion, tachycardia and hypotension. Dehydration is caused by water remaining unabsorbed in the bowel and losses from vomiting without the ability to replace orally. [patient.info]

    […] empty) Previous abdominal operations or obstructive episodes History of inflammatory bowel disease Known gallstones, diverticular disease, or hernias Previous malignancies or abdominal radiation Physical examination should take note of: Tachycardia, hypotension [clinicaladvisor.com]

Neurologic

  • Confusion

    Cocoon abdomen may be confused with congenital peritoneal encapsulation, which is characterized by a thin accessory peritoneal sac surrounding the small bowel, and is an incidental finding [12]. [casereports.in]

    That may be confusing, we are just seeing if you are paying attention. In the left photo, the right fallopian tube is stuck to the back of the uterus. The right ovary can be seen `peeking out` below the tube. [fwcenterforpelvicmedicine.com]

    Diarrhoea and vomiting will also cause very active bowel sounds that may be confused with the tinkling of obstruction Ischaemia of the gut can cause pain and distension but there is usually bloody diarrhoea. [patient.info]

    As the hernia enlarges, it turns upwards into the looser areolar tissue beneath the skin of the groin crease and may be confused with an inguinal hernia. Sagittal section of a femoral hernia. [surgwiki.com]

Urogenital

  • Oliguria

    Investigations Fluid charts are required to monitor intake and output, especially as an intravenous infusion is almost certainly required, a nasogastric tube may be passed and oliguria is an important sign of early dehydration. [patient.info]

Workup

Workup should include WBC, lactate, electrolytes, BUN/creatinine. [unboundmedicine.com]

Treatment

Non-surgical treatments for adhesions Alternatives to surgery include: medication – this is often the first treatment choice for acute pain and forms part of the treatment for chronic pain exercise physical therapy lifestyle changes. [betterhealth.vic.gov.au]

Treatment – Surgical Indications : When conservative treatment for 3 to 5 days does not result in resolution When strangulation is suspected / cannot be ruled out 8. [slideshare.net]

Babies with birth defects often need special care and treatments. The treatments may include surgery, medicines, assistive devices, and therapies. [icdlist.com]

Principles of treatment Uncomplicated hernias require either no treatment, support with a truss, or operative treatment, whereas complicated hernias always require surgery, often urgently. [surgwiki.com]

Intestinal Adhesions Introduction Symptoms Diagnosis Treatment Prevention Intestinal adhesions are bands of fibrous tissue that can connect the loops of the intestines to each other, or the intestines to other abdominal organs, or the intestines to the [hemorrhoid.net]

Prognosis

] The prognosis of advanced carcinoma of the colon remains poor. [patient.info]

Long term postoperative prognosis is generally excellent. Conclusion Abdominal cocoon is a rare condition of unknown etiology. [casereports.in]

Ongoing Care Prognosis Adhesions are typically asymptomatic. Once present, they cannot be fully removed. No single approach has been satisfactory in removing adhesions. [unboundmedicine.com]

Prognosis of small- bowel obstruction depends on the location and source of obstruction. [laparoscopyhospital.com]

Prognosis Intestinal obstruction surgery usually has a favorable outcome if the surgery is performed before tissue damage or death occurs. [medical-dictionary.thefreedictionary.com]

Etiology

Despite various hypotheses, the etiology remains unknown. It could be primary or secondary. [casereports.in]

Etiological spectrum of dynamic intestinal obstruction. Gomal J Med Sci. 2007; 5 :59 – 61. 4. Parashar UD, Holman RC, Cummings KC, Staggs NW, Curns AT, Zimmerman CM, et al. [tropicalgastro.com]

The etiology of adhesions is usually related to prior abdominal surgery, although congenital bands and adhesions from intraabdominal or pelvic inflammatory processes may be responsible. [newportlaparoscopy.net]

The etiologic factors could be either congenital or acquired causes. [ijri.org]

Etiology: Primary - Idiopathic Seen in children; no lead point Peak incidence 3 - 9 months Hyperplasia of Payer’s patches in the terminal ileum - Secondary to weaning - URTI due to adenovirus or rotavirus Adults – Secondary Meckel’s diverticulum, HS Purpura [slideshare.net]

Epidemiology

Epidemiology Incidence True incidence is difficult to determine because some adhesions are asymptomatic. [unboundmedicine.com]

Attard, J.A.P. and MacLean, A.R. (2007) Adhesive small bowel obstruction: Epidemiology, biology and prevention. Canadian Journal of Surgery, 50, 291-300. [file.scirp.org]

Epidemiology Of all patients admitted to hospital with intestinal obstruction, most have small intestinal obstruction. Significant numbers of colorectal malignancies present with obstruction. [patient.info]

Pathophysiology

Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011;17(41):4545–4553. [View Abstract on OvidMedline] Diamond MP, Burns EL, Accomando B, et al. [5minuteconsult.com]

Pathophysiology [ edit ] Adhesions form as a natural part of the body’s healing process after surgery in a similar way that a scar forms. [en.wikipedia.org]

Pathophysiology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011;17(41):4545–4553. [PMID:22147959] Moris D, Chakedis J, Rahnemai-Azar AA, et al. [unboundmedicine.com]

In article View Article [4] Liakakos T., Thomakos N., Fine P.M., Dervenis C., Young R.L., “Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management,” Dig Surg, 18(4). 260-273. 2001. [pubs.sciepub.com]

Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan. Br J Surg, 90 (2003), pp. 533-541 [27] R.S. Williams, A.M. Rossi, N. Chegini, G. Schultz. [elsevier.es]

Prevention

Experts in the field contribute to clinical standards for preventive measures to control the formation of postoperative adhesions [books.google.com]

Recent advances in prevention and management". Digestive Surgery. 18 (4): 260–73. doi : 10.1159/000050149. [en.wikipedia.org]

Primary prevention: Avoid abdominal infection or need for abdominal surgery. [unboundmedicine.com]

Such adhesions can cause Asherman's syndrome, closing the uterus and preventing menstruation. [medical-dictionary.thefreedictionary.com]

Prevention Methods to prevent adhesions include using biodegradable membranes or gels to separate organs at the end of surgery or performing laparoscopic (keyhole) surgery, which reduces the size of the incision and the handling of the organs. [hemorrhoid.net]

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