Presentation
It usually remains asymptomatic in mild cases, but if severe, may present with chronic and vague RUQ abdominal pain which may be intermittent or persistent. [ncbi.nlm.nih.gov]
Gastrointestinal
- Dyspepsia
Empiric and symptomatic treatment such as those available for dyspepsia (e.g. simethicone, proton pump inhibitors, nortriptyline) are often attempted but are of variable efficacy, depending on the extent to which symptoms are attributable to adhesions [ncbi.nlm.nih.gov]
Workup
Colonoscopy
- Colitis
Crohns Colitis. 2013 Jul; 7 (6):467–473. [ PubMed ] [ Google Scholar ] 13. Tingsted B., Isakson J., Anderson R. Long term follow up and cost analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br. J. [ncbi.nlm.nih.gov]
Treatment
The lack of amenability of all adhesions to surgical treatment cannot be overemphasized. [ncbi.nlm.nih.gov]
The NIH places the annual cost of post-surgical adhesion treatment as high as $1 billion. [upi.com]
"American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of carpal tunnel syndrome". The Journal of Bone and Joint Surgery. American Volume. 92 (1): 218–9. doi : 10.2106/JBJS.I.00642. [en.wikipedia.org]
Etiology
Nevertheless, as mentioned earlier, abdominal imaging is valuable to rule out other etiologies for a patient's symptoms. [ncbi.nlm.nih.gov]
"Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management". Digestive Surgery. 18 (4): 260–73. doi : 10.1159/000050149. [en.wikipedia.org]
Pathophysiology
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 Nov 7; 17 (41):4545–4553. [ PMC free article ] [ PubMed ] [ Google Scholar ] 29. [ncbi.nlm.nih.gov]
Prevention
Recent advances in prevention and management". Digestive Surgery. 18 (4): 260–73. doi : 10.1159/000050149. [en.wikipedia.org]
Dextran has been used successfully to prevent thrombosis of small arteries and large veins following trauma to the intima. 4,5 The mechanism by which dextran prevents thrombosis remains obscure. The total plasma volume [jamanetwork.com]
When abnormal fibrous connections known as adhesions grow, they can bind organs to the abdominal wall following surgery, preventing the organs from sliding around as they should. [upi.com]
Prevention of postoperative peritoneal adhesions: a review of the literature. AMJ Surg. 2011 Jan; 201 (1):111–121. [ PubMed ] [ Google Scholar ] 32. [ncbi.nlm.nih.gov]