Presentation
Adhesions present at the time of the second-look procedure were reduced from initial presentation at most sites; however, nonlaser infertility surgery appeared to have equal or greater efficacy in the prevention of adhesion formation at most sites. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
OBJECTIVE: To demonstrate the presence of nerve fibers in pelvic adhesions potentially capable of conducting pain stimuli. METHODS: Pelvic adhesions from 17 patients, ten of whom had a history of pelvic pain, were examined histologically. [ncbi.nlm.nih.gov]
This leads to a very important distinction between chronic pelvic pain and episodes of other pain that we might experience during our life: usually pain is a symptom, but in chronic pelvic pain, pain becomes the disease." [adhesions.org]
pain with adhesions, hysterectomy, IBS, painful bowel movements, bowel obstruction, bladder pain, lower back (sacroiliac joint) pain, painful intercourse, possibly vulvodynia and interstitial cystitis. [hormonesmatter.com]
- Surgical Procedure
Abstract Pelvic adhesions occur following the vast majority of surgical procedures. Surgical technique is the most important consideration to reducing adhesions. [ncbi.nlm.nih.gov]
- Fever
Fever is usually minimal or occurs later in the process. Such intestinal blockage can correct itself. [emedicinehealth.com]
Fever may increase. Further progression can tear your intestinal wall and contaminate your abdominal cavity with bowel contents. When to Seek Medical Care See a doctor any time you experience abdominal pain, pelvic pain, or unexplained fever. [webmd.com]
- Asymptomatic
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]
This scar tissue can be completely asymptomatic and not cause any problems. [innovativegyn.com]
Scar tissue can be completely asymptomatic and not cause any problems. [gynsurgeryinfo.org]
Pelvic infections (PID) They are asymptomatic in 15% of cases. They are ascending or proximal (appendicitis). Chlamydia is responsible for 50% of cases. [layyous.com]
- Fatigue
These can include a whole host of other possible diagnoses such as chronic fatigue syndrome, endometriosis, irritable bowel syndrome, fibromyalgia, depression and anxiety. [betterhealth.vic.gov.au]
Sleep may then be impaired, leaving the patient chronically fatigued. Posture and gait may change subtly, allowing stiff low back and leg muscles to increase the discomfort. [glowm.com]
Gastrointestinal
- Abdominal Pain
Related Articles: Left Side Abdominal Pain Right Side Abdominal Pain Acute Severe Abdominal Pian Chronic Constipation References: Asherman’s syndrome caused by intrauterine adhesions (nwh.org) Adhesions between the liver and diaphragm in STD (emedicine.medscape.com [healthhype.com]
They are the common cause of abdominal pain and bowel blockages. Adhesions in the pelvis and abdomen occurs due to inflammation of the inner lining of abdominal organs. [beverlyhillsurogyn.com]
Adhesions may be responsible for chronic persistent abdominal pain without associated pelvic pathology. Though adhesions probably cause pain by entrapment of expansile viscera, the relationship of adhesions to abdominal pain is still controversial. [endogyn.com]
Abdominal adhesions are important because they are a common cause of abdominal symptoms, particularly abdominal pain and they can cause bowel blockages or obstruction. [medicinenet.com]
- Nausea
Symptoms of this disorder, known as strangulation, include sudden, severe, crampy or steady abdominal pain, nausea, vomiting and rectal bleeding. 3. [healthhype.com]
If adhesions stretch or constrict a vital structure, such as the bowel, this can result in pain and other symptoms, such as bowel obstruction and nausea. [vitalhealth.com]
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 long-term (chronic) pelvic pain. [ufhealth.org]
- Intestinal Disease
”[tiab] OR intestinal disease/surgery[mesh] OR abdomen/surgery[mesh] OR peritoneum/surgery[mesh] OR Laparoscopy[mesh] OR laparotomy[mesh] OR laparo*[tiab] Intervention Tissue adhesions[mesh] OR adhes*[tiab]) AND (abdo*[tiab] OR abdomen[mesh] OR pelvis [bmj.com]
- Hematochezia
View/Print Table Table 2 Selected Findings on History, Physical Examination, and Diagnostic Studies Finding Possible significance History Hematochezia Gastrointestinal malignancy/bleeding History of pelvic surgery, pelvic infections, or use of intrauterine [aafp.org]
- Abdominal Bloating
I advise my patients who’ve had surgery to switch to a liquid diet for a day if they start experiencing any abdominal bloating or cramping. That’s frequently all it takes to get discomfort from adhesions under control. [health.clevelandclinic.org]
Cardiovascular
- Chest Pain
When to Seek Medical Care for Adhesions See a doctor any time a person experiences abdominal pain that doesn't resolve quickly, pelvic pain, chest pain, or unexplained fever. [emedicinehealth.com]
Call 911 and go to the nearest emergency department if chest pain occurs. [webmd.com]
Skin
- Ulcer
Inflammation The following can be caused by: Inflammation: pelvic inflammatory disease, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) appendicitis, especially if the appendix ruptures. Endometriosis. [pelvicpain.org.uk]
Inflammation Inflammation, like appendicitis, pelvic inflammatory disease (PID), Crohn’s disease or ulcerative colitis may all result in adhesions. 3. [healthhype.com]
Inflammatory and infectious processes that can cause adhesions include: SIBO colitis gastritis hepatitis diverticulitis appendicitis cholecystitis endometriosis gastroenteritis perforated ulcer cystitis or vaginitis pelvic inflammatory disease (PID) perforated [clearpassage.com]
Psychiatrical
- Fear
I have found that they seem to fear that the examination will go on interminably, even if severe pain is experienced. [glowm.com]
Neurologic
- Irritability
Adhesions are scar tissues that develop within the body in response to any chronic irritation. [thenewjerseypelvicpaincenter.com]
The most common are: Irritable Bowel Syndrome Irritable bowel syndrome (IBS) can cause diarrhea, constipation, or a combination of both. Symptoms of bloating and discomfort may be relieved by a bowel movement. [ucsfhealth.org]
Adhesions, when they are involved in causing pain, are usually present along with some other disease process that can cause pain, such as irritable bowel syndrome (IBS) or endometriosis. [med.unc.edu]
Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. [aafp.org]
Urogenital
- Pelvic Pain
OBJECTIVE: To demonstrate the presence of nerve fibers in pelvic adhesions potentially capable of conducting pain stimuli. METHODS: Pelvic adhesions from 17 patients, ten of whom had a history of pelvic pain, were examined histologically. [ncbi.nlm.nih.gov]
Chronic pelvic pain is defined as pain that lasts longer than six months. [clearpassage.com]
If the bowel becomes obstructed, distention will cause pain. Some patients in whom chronic pelvic pain has lasted more than six months may develop "Chronic Pelvic Pain Syndrome.” [adhesions.org]
- Dyspareunia
You can expect a quicker, less painful recovery from: Endometriosis Uterine fibroids Interstitial cystitis Pelvic floor dysfunction Dyspareunia (pain with intimacy) Pelvic adhesions, scar tissue and other causes of pelvic pain You do not have to accept [maternalgynerations.net]
For example, adhesions involving the female reproductive organs (ovaries, Fallopian tubes) can and do cause infertility, dyspareunia (painful intercourse) and debilitating pelvic pain. [edsinfo.wordpress.com]
#1 I have a question regarding coding of lap. lysis of pelvic adhesions: Our physicians' dictation states as follows (I am only putting the information pertinant to the procedure): Preop Diagnosis: Pelvic pain, dyspareunia, probable pelvic adhesive disease [aapc.com]
- Pelvic Pain in Women
Pelvic Pain in Women Pelvic pain is more common in women. There are many different causes of pain in your pelvis. [patient.info]
Pain in Women Figure 2 Algorithm for the evaluation and treatment of chronic pelvic pain in women presenting to primary care. [aafp.org]
Other studies find that adhesions are the most common reason for chronic pelvic pain in women. This pain occurs because adhesions bind together normally separate organs and tissues. [healthywomen.org]
- Dysmenorrhea
Combined oral contraceptive pill (OCP) as treatment for primary dysmenorrhea. Cochrane Database Syst Rev. 2001(4):CD002120. 22. Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. [aafp.org]
These cells then create an acute inflammatory reaction during menses that can result in pain (dysmenorrhea) and/or local pelvic adhesions. [thenewjerseyfemaleinfertilitycenter.com]
Workup
View/Print Table SORT: KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation Evidence rating References If the initial history and physical examination do not reveal a specific diagnosis, the initial diagnostic workup should include: a complete blood [aafp.org]
Workup should include WBC, lactate, electrolytes, BUN/creatinine. [unboundmedicine.com]
Colonoscopy
- Colitis
Inflammation The following can be caused by: Inflammation: pelvic inflammatory disease, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) appendicitis, especially if the appendix ruptures. Endometriosis. [pelvicpain.org.uk]
Inflammation Inflammation, like appendicitis, pelvic inflammatory disease (PID), Crohn’s disease or ulcerative colitis may all result in adhesions. 3. [healthhype.com]
Inflammatory and infectious processes that can cause adhesions include: SIBO colitis gastritis hepatitis diverticulitis appendicitis cholecystitis endometriosis gastroenteritis perforated ulcer cystitis or vaginitis pelvic inflammatory disease (PID) perforated [clearpassage.com]
Treatment
OBJECTIVE: Aim of the study was to test the effectiveness of pharmacological treatment and regional anesthesia techniques for pain control as the next step of treatment after the lack of clinical results of surgical and pharmacological methods normally [ncbi.nlm.nih.gov]
Treatment of adhesions Most people who have adhesions don’t need any treatment for them as, often, they don’t cause problems. [bupa.co.uk]
Prognosis
Agreement was present between surgeons regarding estimated prognosis for microsurgery and also in recommending management, particularly when prognosis was considered poor and IVF was recommended. [ncbi.nlm.nih.gov]
Outlook (Prognosis) The outcome is good in most cases. Possible Complications Adhesions can cause various disorders, depending on the tissues affected. In the eye, adhesion of the iris to the lens can lead to glaucoma. [ufhealth.org]
Avoiding repeated surgical adhesion removal, since each operation raises a risk for new adhesions Adhesions Formation Pathophysiology and Prognosis Within few hours after a surgical procedure (or other cause of tissue injury), inflammatory cells and fibrin [healthhype.com]
Adhesions Prognosis Adhesions requiring surgery commonly come back because surgery itself causes adhesions. [emedicinehealth.com]
Etiology
RESULTS: There was a strong correlation between the degree of intratubal damage and the extent of pelvic adhesions when the etiology was previous pelvic inflammatory disease (PID) but not when the underlying etiology was endometriosis. [ncbi.nlm.nih.gov]
A unifying Pathogenic Mechanism in the Etiology of Intraperitoneal Adhesions. J. Surg. Research. 20: 1–5. CrossRef Google Scholar 9. O'Leary, D. P., and J. B. Coakley. 1992. [link.springer.com]
The etiologic factors could be either congenital or acquired causes. [ijri.org]
With her husband, massage therapist Larry Wurn, Belinda took a much deeper look at the etiology and biomechanics of adhesion formation. [clearpassage.com]
Monk, B.J., Berman, M.L. and Montz, F.J. ( 1994 ) Adhesions after extensive gynecologic surgery: Clinical significance, etiology, and prevention. Am. J. Obstet. Gynecol. 170, 1396 –1403. [academic.oup.com]
Epidemiology
[…] rzteblatt International, 107, 769-775. [ 14 ] Attard, J.A.P. and MacLean, A.R. (2007) Adhesive small bowel obstruction: Epidemiology, biology and prevention. [scirp.org]
Adhesion-related readmissions following gynaecological laparoscopy or laparotomy in Scotland: an epidemiological study of 24 046 patients. Hum Reprod 2004 ; 19 : 1877 -85. ↵ Higgins J, Green S. [bmj.com]
Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus. 2006; 15(5): 308-318. PubMed | Google Scholar Nietert PJ, Mitchell HC, Bolster MB, Shaftman SR, Tilley BC, Silver RM. [panafrican-med-journal.com]
Epidemiology Incidence True incidence is difficult to determine because some adhesions are asymptomatic. [unboundmedicine.com]
Pathophysiology
Adhesions share an array of characteristics with many other diseases whose pathophysiology lies on fibroblastic activity. [panafrican-med-journal.com]
OBJECTIVE: The pathophysiologic processes that result in wound healing are the same regardless of the tissue involved. [ncbi.nlm.nih.gov]
Pathophysiology of Pelvic pain Go top Pathophysiology of pelvic pain is specific and different from other somatic pain : different nociceptors, different activation. See slides of a presentation on pathophysiology. [gynsurgery.org]
Prevention
Some major landmarks led to the development of the intraperitoneal substances currently used to prevent postoperative pelvic adhesions. [ncbi.nlm.nih.gov]
What surgical techniques help prevent adhesions? DECHERNEY: Let’s review the aspects of surgical technique that are important for adhesion prevention. [mdedge.com]
Use of adhesion prevention products Some adhesion prevention products have been removed from the market in recent years. [pelvicpain.org.uk]