Definition: Intestinal adhesions are abnormal adhesions between the intestinal tube and the intestinal tube, between the intestinal tube and the peritoneum, and between the intestinal tube and the intra-abdominal organs due to various causes.
Characteristics: Intestinal adhesions mostly occur after surgery, especially after appendicitis or pelvic surgery. The severity of intestinal adhesions is related to the sensitivity of the individual to the injury response of the peritoneum or the plasma membrane of the intestinal canal. There are two types of adhesions: membranous adhesions and cord-like adhesions; their nature is fibrinous and fibrous adhesions.
Symptoms: The clinical symptoms and manifestations caused by intestinal adhesions vary depending on the degree of adhesions and the site of adhesions.
In mild cases, there may be no discomfort and clinical symptoms, or occasional mild abdominal pain and bloating after eating, which can be relieved by themselves.
In severe cases, there may be frequent abdominal pain, abdominal distension, dysphagia, belching, dry stools, and gas clots in the abdomen, which may even cause incomplete or complete intestinal obstruction.
Etiology: In addition to congenital causes, the formation of adhesions is no more than two factors: injury and inflammation.
Injury: 1, surgery: the process of intestinal tube exposure, pulling, plasma membrane damage, postoperative blood leakage, exudate, intra-abdominal placement of drains, etc. can cause intestinal adhesions; 2, abdominal trauma: closed abdominal trauma, the impact site is not ruptured perforation, but the local tissue of the injury can appear congested edema or bloody exudate into the abdominal cavity, so that the surrounding tissue edema adhesions; 3, chemical drugs: such as family planning sticky plug drug outflow , into the abdominal cavity causing adhesions.
Inflammation: 1, pelvic and abdominal organs bacterial infection (appendicitis, cholecystitis, adnexitis), resulting in inflammatory exudate or pus pelvic and abdominal accumulation, causing adhesions; 2, tuberculous peritonitis: tuberculous peritonitis can be divided into two types of dry and wet dry type, peritoneal in addition to tuberculous nodules still have a large amount of fibrinous exudate, mechanization triggered by extensive adhesions in the abdominal organs, large omentum and intestinal tract; 3, intestinal TB 3. Intestinal tuberculosis: Patients with intestinal tuberculosis have fibrinous exudates and nodules in the plasma membrane of the intestinal wall, and often ulcers leading to vascular occlusion of the intestinal wall. At the same time, the intestinal wall often forms adhesions with the adjacent intestinal tube or large omentum due to fibrous hyperplasia.
4.Other: Infiltrative growth of tumor destroys surrounding tissues and forms adhesions.
Prevention: Intestinal adhesions mostly occur after surgery, especially after appendicitis or pelvic surgery.
1.Gentle operation, pay attention to the protection of intestinal canal, strict hemostasis and thorough flushing of abdominal cavity; 2.Intraoperative application of absorbable anti-adhesion biological material can reduce the occurrence of adhesions; 3.Early postoperative activity to promote gastrointestinal peristalsis is the key.
Treatment: Some adhesions can be partially or fully absorbed later, and surgical treatment does not eliminate adhesions, instead, new adhesions are bound to be formed after surgery, so intestinal adhesions are generally treated non-operatively.
The normal intestinal peristalsis can expel the food residue and gas from the intestinal cavity, while intestinal adhesions narrow the intestinal canal due to the adhesions, the intestinal contents are obstructed, the pressure in the intestinal cavity increases, and abdominal pain and distension appear. In terms of diet, we should pay attention to: eat less stimulating and fiber-rich food, do not eat cold food, do not drink cold drinks, soft and semi-liquid food such as porridge, steamed buns, cakes, milk, soy milk, etc., should eat less and more meals, do not overeat, avoid drinking a lot of water and liquid diet. In addition, attention should be paid to keeping the abdomen warm, as a cold abdomen will stimulate increased intestinal peristalsis and cause intestinal obstruction.
Surgical treatment is often a last resort, and surgery is considered in the following cases: 1. Adhesive intestinal obstruction with intestinal strangulation after non-surgical treatment is ineffective.
2.After being relieved by non-surgical treatment, recurrent intestinal obstruction occurs.