Adhesions in the abdomen

Adhesions in the abdominal cavity, also called adhesions, often occur between the peritoneum and the serosa, a skin covering the abdominal viscera. Adhesions are often caused by operations, after which the tissue heals and partly scars. Minimally invasive procedures, such as laparoscopy, result in fewer adhesions.

But inflammation in the abdominal cavity can also be a cause. In most cases, adhesions do not lead to complaints. However, it is possible that they restrict the mobility of the bowel or even trap the intestine, which may require emergency surgery.

In the long term, recurring pain and stool irregularities may also occur. In case of serious problems, the adhesions must be removed. This is usually done in a laparoscopy to keep the risk of problematic adhesions reoccurring low.

Existing adhesions are also removed in the case of renewed operations. Cutting through the adhesions, however, causes small wounds, which can lead to new adhesions during the healing process. In general, the surgical removal of adhesions does not have a good chance of success, so that problems caused by adhesions are not normally treated surgically. Attempts are made to alleviate the symptoms with medication or alternative therapies.

Free fluid in the abdomen

Free fluid in the abdominal cavity can be different fluids. Possible fluids are blood, pus, wound fluid, urine and food pulp. Which fluid is involved is cause-specific.

Urine is found in the case of accidental damage to the bladder or leakage after operations on the draining urinary tract. Food gruel is also a conceivable cause of leakage of organs due to accidents or serious infections. Wound fluid and pus are usually the result of inflammations and infections in the abdominal cavity.

If an inflamed appendix or diverticulum ruptures, these can enter the abdomen and cause severe peritonitis. Blood gets into the abdomen especially in accidents. As a result of traffic accidents, large organs with a good blood supply such as the spleen can tear and bleed into the abdomen.

A rupture in an aneurysm can also cause a lot of blood to enter the abdomen. Free fluid in the abdominal cavity always has a disease value and requires treatment. In the case of serious injuries, the abdominal cavity is already checked for free fluid in the abdomen in the shock room of the emergency room.

This allows conclusions to be drawn about internal injuries. The fluid always collects in the deepest point. When standing, this is the pelvis and when lying down, an area near the kidneys.

Basically, all blood in the human body is intravascular, i.e. within blood vessels. When blood enters the abdominal cavity, it therefore always has a disease value. One cause of blood in the abdominal cavity is tearing of the abdominal organs.

This can be caused by inflammation or accidents. In the case of inflammation in the abdomen, such as appendicitis or diverticulitis, vessels can be damaged and, if the affected organ tears, they can carry blood into the abdomen in addition to pus and wound fluid. Such ruptures are always life-threatening.

In traffic accidents, ruptures in organs can also occur independently of any previous damage. The liver and spleen, both of which are very well supplied with blood, are particularly at risk. Likewise, large vessels can also tear directly if they are exposed to strong forces.

Persons with previous damage to the vessels can also develop protrusions of the vessel wall, so-called aneurysms. These can also rupture independently of an accident and are a direct indication for surgery. In this case, many affected persons do not make it to a clinic in time.

In women, endometriosis or abdominal pregnancy may be an additional cause of abdominal bleeding. In the first case, the endometrium is the lining of the uterus outside the uterus, which is broken down depending on the cycle. An abdominal pregnancy is an embryo that implants itself outside the uterus and can infiltrate large blood vessels. An acute bleeding in the abdomen is always an emergency.