Adhesions

Abstract

Intraabdominal adhesions continue to be a source of significant morbidity worldwide. Up to 10% of patients who have undergone abdominal operations will develop an obstruction requiring hospitalization. This translates to 300,000 admissions and 1.3 billion dollars in the United States each year. Additionally, pelvic adhesions may be responsible for 20% of cases of infertility. Much has been elucidated regarding the pathogenesis of their formation, beginning with the normal inflammatory cascade and ending in adhesions that result in these adverse clinical sequelae. As a result of the knowledge gained, new technology, including systemic pharmacologic and intraperitoneal therapy (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs], tissue plasminogen activator analogs, Seprafilm, Intraceed), and laparoscopic techniques, have emerged, which may decrease peritoneal adhesion formation.