What Are Bowel Adhesions?

Intestinal adhesion refers to abnormal adhesion between the intestinal tube and the intestinal tube, between the intestinal tube and the peritoneum, and between the intestinal tube and the abdominal organs caused by various reasons. Simple intestinal obstruction and incomplete obstruction, especially those with extensive adhesions, are generally treated with non-surgical treatment. A narrow intestinal obstruction is suspected, especially closed occlusive obstruction, and surgery must be performed early to prevent intestinal necrosis. Surgical treatment should also be considered for recurrent and frequent adhesive intestinal obstruction.

Basic Information

English name

intestinal adhesion

Visiting department

General Surgery

Common locations

intestinal

Common causes

Surgery, abdominal trauma, tuberculous peritonitis, intestinal tuberculosis, intra-abdominal inflammation, etc.

Common symptoms

Abdominal pain, mechanical intestinal obstruction

Causes of intestinal adhesions and common diseases

In addition to congenital causes, the formation of adhesions is mainly caused by trauma, bleeding, infection, and foreign body stimulation in the abdominal cavity.

Damage

(1) Surgery

Long bowel exposure during surgery, rough movements, large wounds, inadequate hemostasis, postoperative bleeding, exudate, poor irrigation of the abdominal cavity, or foreign bodies left in the abdominal cavity may cause intestinal adhesions;

(2) Abdominal trauma

The abdomen is suddenly impacted by the outside world. Although the impacted part is not broken and perforated, there is also some damage or bloody exudate flowing into the abdominal cavity, which makes the surrounding tissue edema and adhesion;

(3) Chemical drugs

Such as family planning occlusion, the outflow of drugs into the abdominal cavity caused serious adhesions.

2. inflammation

(1) Intraabdominal inflammation

Causes inflammatory edema, exudate or pus overflowing into the abdominal cavity causing adhesions;

(2) Tuberculous peritonitis

Causes intestinal adhesions. Tuberculous peritonitis can be divided into dry and wet types. The dry type is characterized by fibrous exudates in addition to tuberculous nodules on the peritoneum. It can cause abdominal organs, omentum, and mesentery after mechanization. Extensive adhesion

(3) Intestinal tuberculosis

Causes intestinal adhesions. Patients with intestinal tuberculosis can see cellulose exudation and most gray-white nodules on the serosal surface of the intestine. At the same time, the intestinal wall often forms adhesions with adjacent intestinal canals or omentum due to fibrous tissue hypertrophy.

3. Other

Such as tumor invasive growth destroys the surrounding tissue to form adhesions or individual intestinal adhesions of unknown origin.

Intestinal adhesion test

1. Based on the relevant manifestations of chronic abdominal pain and recurrent history of mechanical intestinal obstruction;

2. According to the imaging examination of the abdominal organs with limited movement;

3. Laparoscopic examination;

4. Visual inspection of abdominal cavity exploration.

Differential diagnosis of intestinal adhesions

Intestinal adhesion symptoms should be identified based on other symptoms and adhesion sites.

1. Abdominal adhesions can be divided into two types: wall adhesions and abdominal adhesions and visceral adhesions between organs. Abdominal wall surgical incision adhesions are the most common, and omentum and bowel are the most common adhesion organs. Patients can often feel chronic drag pain around the abdominal wall incision, especially when the abdominal wall movements of the body dorsal flexion increase, which is called "large omentum adhesion syndrome".

2. Intestinal dyskinesia is a common cause of intestinal adhesions. Patients show paroxysmal abdominal cramps, often accompanied by bloating and constipation, which is relieved with the appearance of anal exhaust defecation.

3. Chronic abdominal pain and recurrent episodes of mechanical intestinal obstruction after mechanical intestinal obstruction are the main criteria for intestinal adhesion. Intestinal adhesions cause the related intestines to be involved, twisted or even angled, the tortuosity is increased, the lumen of the intestines is narrowed to varying degrees, and the resistance to movement of the intestinal contents is increased, which can lead to poor digestion and paroxysmal abdominal colic When intestinal dysfunction is easily converted into mechanical intestinal obstruction.

Intestinal adhesion treatment principles

It is important to treat adhesion intestinal obstruction to distinguish between simple or strangulated, complete or incomplete. Traditional Chinese medicine can be treated with compound Dachengqi decoction, and those with mild signs and symptoms use raw vegetable oil or Liqi Kuanchang Decoction. It can also be used to acupuncture Zusanli. Adhesive intestinal obstruction is not improved or worsened by non-surgical treatment, or narrower intestinal obstruction is suspected, especially closed obstruction, and surgery must be performed early to prevent intestinal necrosis. Surgical treatment should also be considered for recurrent and frequent adhesive intestinal obstruction.