ADHESIONS: THE SILENT GROWTHS
By: Jennifer Lewis
One of the complications of multiple surgeries for endometriosis is the
formation of scar tissue or adhesions. These are not endometrial growths, but
scar bands created due to the removal of endometrial tissue during surgery or
surgery itself. Adhesions can also form around incision sites within the
abdomen. These "Bands" can often bind pelvic organs, block tubes and ovaries
preventing pregnancy and also block or suffocate the bowel causing a bowel
Adhesions in and of themselves are also painful without the presence of
endometriosis, so it is often difficult for a woman who has had multiple
surgeries or one who has adhesion with no other form of endometriosis to
determine if her pain is from recent endometriosis or adhesions alone. This
is problematic as treatment for adhesions are surgical, thus, risking the
formation of further scar tissue. If this sounds like a viscous cycle you're
right - Adhesions can form within hours after surgery!
I have had numerous laparoscopies and laparotomies including a total
hysterectomy. Six months after my radical hysterectomy I awoke with a severe
stomach ache. The pain was about three to five inches above my navel and it
felt like someone was trying to tie a knot inside of me. After an abdominal
series of X-Rays it was determined that I had a bowel obstruction due to an
adhesional blockage. Essentially, scar bands had developed and wrapped
themselves around my small bowel creating a blockage. After a trial
decompression treatment using a naso-gastric, or NG tube, ( a tube that is
inserted into your nose and down into your stomach ) I was deemed no better
and rushed into surgery. The laparotomy was extensive and the incision was
from the pubic line all the way up past my navel. Ouch! The surgeon had to
clip the scar bands that were suffocating the bowel and causing the blockage.
I was fortunate in that I needed no colostomy bag and no resection. In some
cases, a temporary colostomy may be required while the other parts of the
severed bowel heal. A resection is where the surgeon actually removes a part
of the bowel then reattaches it.
I was devastated. I knew that this surgery had left behind even more scar
tissue and adhesions. It was not anyone's fault, just a possible side effect
of both endometriosis and surgery. When the surgeon opened me up they found
massive adhesions all over my bowel and intestine. Part of my bowel had slid
down to where my uterus once was. I was told there was no way they could
safely remove all the adhesions without creating more and that they did
excise what they could. They used Surgiceed afterwards. Surgiceed, and other
barrier methods, work to form a wall or barrier between the surgical area and
the scar tissue, The intent is to help create less friction and cohesion.
Hence, fewer adhesions.
The most common sits for adhesions are the pelvic organs, adhesing to the
bowel, uterus, tubes and ovaries. They can also form over
endometrial implants themselves, Having adhesions on or around the bowel can
mimic several other intestinal disorders. It is imperative that you seek
medical Help immediately if you have any of the following:
1. Sharp, Stabbing or strangulating pain in the center of your abdomen.
2. Projectile vomiting that appears green ( from your gall bladder 0 or
brown, accompanied by a foul stench.
3. Absence of gas and a severe bloated feeling.
Any of these symptoms should be checked out by a physician to rule our
So what can be done? There are newer techniques used during surgery to
prevent formation, as well, as speculation as to why they occur so rapidly.
One method is insertion of a degradable substance that gets absorbed by the
body within a few weeks post operative. Newer techniques are on the horizon.
Author, Endometriosis: One Womans Journey