ABSTRACT
Although for many patients, most adhesions have little or no detrimental effect, a sizeable proportion of cases lead to serious short and long term consequences. Adhesions are the most common cause of bowel obstruction and most likely result from gynecologic procedures, appendectomies, trauma, and other intestinal operations. Adhesions have also been proposed as a cause of infertility and abdominal and pelvic pain. Although nerve fibers have been confirmed in pelvic adhesions, their presence is not increased in those patients with pelvic pain. In addition, there does not appear to be an association between the severity of adhesions and the complaint of pain. It is generally accepted that adhesions may impair organ motility resulting in visceral pain transmitted by peritoneal innervation. Many patients experience resolution of their symptoms after adhesiolysis. This may be complicated by placebo effect as demonstrated by one study that showed no difference in pain scores between patients who
expectant management.
