Scandinavian journal of gastroenterology. Supplement
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Scand. J. Gastroenterol. Suppl. · Jan 2000
ReviewRecent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions.
Postsurgical intra-abdominal adhesions pose a significant medical problem in the Western world, and in the past decade progress has been made in understanding their pathophysiology. The early balance between fibrin formation and degradation in the peritoneal cavity during and after surgery seems to be a major determinant of adhesion formation. Postsurgical inhibition of fibrinolytic activity severely impairs fibrin breakdown. ⋯ Roughly 3% of all surgical admissions are associated with intra-abdominal adhesions. Clinical prospective trials have recently been designed to investigate the efficacy of barrier membranes and gels in the reduction of abdominal and pelvic adhesions and prevention of long-term morbidity, e.g., adhesive bowel obstruction and infertility in women. Early results are promising and contribute to the increased interest among clinicians in postsurgical adhesion formation and its consequences.