Adhesion is an abnormal joining of two contiguous tissues or organs by a connective tissue. Post-surgical adhesions must be differentiated from muscle adhesions common in athletes.
What is the definition of an adhesion in medicine?
Adhesion is a pathological joining by connective tissue of two adjacent tissues or organs usually separated. Post-surgical adhesions can be found at different levels of the body: at the level of the abdomen or pelvic tissue, For example.
What is an abdominal adhesion?
Abdominal adhesion is a medico-surgical pathology that touches the peritoneum, membrane that surrounds the viscera, at the time of healing. “When you have belly surgery laparotomy (inflate the belly with gas to create enough space to operate), one can have scarring, fibrous adhesions which can interfere with intestinal mobility or that of the intra-abdominal viscera“, notes Dr. Chaouchi, gastroenterologist and interventional hepatologist.
What is a pelvic adhesion?
The female genitalia can also be the seat of adhesions, when the surfaces of two distinct pelvic structures stick together. They are often due to a intrapelvic pathology (salpingitis) or intrapelvic infection (peritonitis). “These inflammatory adhesions can settle and become chronic adhesions and then interfere with the physiology of the intrapelvic organs, in particular the genitals: ovaries, uterus, rectovaginal septa, rectum. Patients may complain of chronic pain at this level“, he underlines.
What is muscle adhesion?
Muscle adhesion is observed when the skin sticks to the tissues and muscles under the skin. It also corresponds to the formation of a flange within the muscle following a trauma (fall, intensive training, injury, etc.). This adhesion is common among athletes.
What are the causes of adhesion between two organs?
Adhesion is often the subject of abnormal fibrous connections following a dysfunction of the healing process of the peritoneum following digestive or gynecological surgery. It can form 3 to 5 days after the operation. “There may be acute inflammatory adhesions in front of any acute intestinal pathology“, adds Dr. Chaouchi.
What are the possible complications of an adhesion?
The complication of an adhesion whatever its location is the loss of mobility, leading to more or less significant disorders. In the viscera: abdominal pain, transit disorders (constipation), pelvic pain and painful periods. “These adhesions can in some cases cause bowel obstruction or episodes of subocclusion“, he adds. Pelvic adhesion can also be the cause of a sterility or infertility if it affects the fallopian tubes, ovaries or be the consequence of salpingitis (infection followed by inflammation of the tubes). At muscle level: muscle pain, swelling, loss of flexibility, muscle strengthe and/or joint mobility.
What tests can diagnose an adhesion?
Imaging examinations make it possible to diagnose adhesion. CT scan or abdominal MRI show the adhesions at the level of the peritoneum or the meso surrounding the small intestine, which will be responsible either for a blockage or a stenosis at the level of a limited segment of the small intestine or for a mechanical blockage of intestinal transit . “In this case, we will see a distension of the intestines, a blockage of the intestinal bolus created by the adhesions“, explains Dr. Chaouchi.
The management of adhesion(s) generally involves a surgical intervention : “it is necessary to unclamp the flange responsible for the discomfort or the mechanical blockage“. The adhesions will then be resected and a specific film (AC film) deposited on the fabrics to soften them. Drug treatment will also be proposed to improve intestinal transit and restore flexibility to the intestines and intra-abdominal viscera. For muscle adhesions, deep tissue massage (fasciatherapy, self-massages, etc.) can also be a good alternative to try to reduce their rigidity.
Thanks to Dr. Karim Chaouchi, gastroenterologist and interventional hepatologist, Floréal clinic, Bagnolet and Nogent-sur-Marne.