Can you tell me anything about adhesions obstructing the intestines? How complicated is the surgery to correct this?

C.

Adhesions in the abdomen are basically bands of scar tissue that form after a surgical procedure is performed in the abdomen or pelvis. Most commonly they form after gynecologic surgery or a procedure involving the colon (such as colectomy or appendectomy). Factors that increase the likelihood that adhesions will form include abdominal infection, poor blood flow in the abdominal vessels and use of certain suture material.

Although these bands may involve any organ in the abdomen, the type of adhesions most likely to cause problems are those affecting the small intestine. Adhesions can cause an external obstruction of the small intestine by crossing over a loop of intestine and preventing intestinal contents from passing through. In fact, the most common cause of obstruction of the small intestines is adhesion formation. Patients who develop obstruction complain of a crampy, abdominal pain, often accompanied by nausea, vomiting and abdominal distention. An X-ray of the abdomen provides information to make the diagnosis.

Patients with obstruction often improve spontaneously after treatment in the hospital with IV fluids and nutrition. However, in some cases, the obstruction is complete or persistent, resulting in "strangulation" of the bowel. These cases may require emergency surgery to remove the adhesions. Some patients may also suffer repeated, frequent episodes of obstruction. In these cases, elective removal of the adhesions is often recommended. This operation, typically done via laparoscopy, involves finding the adhesions and then cutting the bands to release the bowel loops they encircle. If you are considering such a procedure, you should find a surgeon who is experienced in performing this operation to discuss the likelihood of success and the chances of adhesion recurrence in your individual case.