Incidence Of Intra-abdominal Adhesions Research Articles

Adhesive disease of the pelvic organs and abdominal cavity

This review presents recent data of domestic and foreign literature on the relevance of the problem of adhesive disease pelvic and abdominal cavities. Incidence of intra-abdominal adhesions varies from 67 to 93% after abdominal surgery, and is almost 97% after open gynecologic procedures. Most often adhesions are formed after operations on the abdominal organs; bleeding into the abdominal cavity; inflammation in the peritoneal cavity; in the presence of foreign bodies in the abdominal cavity; at a local tissue ischemia. Leading point of pathogenesis of adhesive disease is inflammation of the peritoneum, accompanied by disorders of local tissue metabolism, and desquamation of the mesothelium and loss of fibrin, that is leads to agglutination of serous membranes. Operations, often resulting in adhesive obstruction include surgery of the colon and rectum, gynecological surgery and emergency appendectomy.

Abdominal adhesions after small intestinal surgery in the horse.

One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7-512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9-512 days) for the survivors and 61 days (range, 7-358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.