ADHESIONS, SEPARATION OF

General Information

DEFINITION--Separation of adhesions, fibrous bands of tissue that cause parts of the abdomen and pelvis to cling together abnormally.

BODY PARTS INVOLVED--Abdominal or pelvic organs.

REASONS FOR SURGERY--

Removal of an intestinal obstruction caused by adhesions. Adhesions usually result from:

• Previous abdominal surgery. > Congenital defects. > Pelvic inflammatory disease. > Endometriosis. > Ruptured ectopic pregnancy. > Radiation treatment for cancers in the abdomen or pelvis. > Any ruptured organ that has caused infection and scarring.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Any chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen over the obstruction.
• The obstruction is isolated and the adhesions are divided carefully.
• The bowel is examined for strangulation (lost blood supply). Any strangulated portion is removed, and the normal ends are joined.
• The abdominal contents are then inspected for undetected disease. Other surgeries may be performed at this time.
• The abdominal contents are replaced. Muscle layers are closed with sutures, and skin is closed with sutures or clips, which can usually be removed in 1 week.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Inadvertent bowel injury.
• Recurrence of adhesions.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non--

prescription drugs, such as acetaminophen, to relieve minor pain.

• Your doctor may prescribe: Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. Stool softeners to prevent constipation. Antibiotics to fight infection.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 5 weeks after returning home. > Resume sexual relations when your doctor determines healing in complete.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† Pain, swelling, redness, bleeding or drainage increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms, such as nausea, vomiting, constipation or abdominal swelling.