Adhesions (adhesive disease) are connective tissue adhesions between adjacent organs or surfaces. Spikes are divided into congenital and acquired. Congenital adhesions appear with congenital malformations of a particular organ. Acquired adhesions develop as a result of inflammatory processes or bleeding into the internal cavities of the body: the unresorbed inflammatory fluid or blood gradually thickens and grows into connective tissue (organizes). At first, the connective tissue is loose and the adhesions are easy to separate, but over time it becomes strong and can even be impregnated with calcium salts, it is very difficult to separate such ossified adhesions. Over time, blood vessels and nerves are found in the adhesions.
Most often, adhesive disease develops as a result of inflammation of the appendix and its removal (appendectomy). Adhesions can also develop as a result of operations for intestinal obstruction, gynecological and urological operations.
In the formation of adhesions in the abdominal cavity, inflammation of the peritoneum takes the leading place. But they can also appear as a result of mechanical damage to the peritoneum (injury), exposure to it of any chemicals (for example, iodine burns). In case of abdominal trauma, prolonged paresis (immobility) of the intestine is important, in which favorable conditions are created for adhesions of intestinal loops due to their prolonged contact with each other.
Adhesive disease can proceed in different ways. Sometimes it begins in the form of a sudden or gradually increasing attack of pain, increased peristalsis (movement) of the intestine, accompanied by vomiting and fever. Signs of intestinal obstruction are quickly detected, the general condition worsens sharply (dehydration is detected due to repeated vomiting, weakness, a sharp decrease in blood pressure).
In some cases, attacks of pain are detected periodically, its intensity is different, sometimes diarrhea, constipation and vomiting disturb.
There is also a long course of the disease with aching pain in the abdomen, discomfort, constipation, impaired general well-being and periodic attacks of acute intestinal obstruction.
The diagnosis of adhesive disease is made on the basis of its typical manifestations, also as a result of x-ray studies of the abdominal organs.
Treatment of adhesive disease depends on its manifestations. Nevertheless, conservative therapy must be the leading one, and surgical intervention should be carried out only when the patient’s life is threatened. Most often, thermal procedures are used: mud, paraffin and ozocerite applications, clay cakes, electrophoresis with medicinal substances (painkillers, absorbable), and so on.
In case of an acute attack that is not resolved with the help of conservative measures for one to 2 hours, surgical treatment is performed (removal of an obstacle to the movement of feces), with multiple attacks – surgical treatment aimed at preventing acute attacks.