Spike after laparoscopy

author: doctor Kuznetsov MA

Adhesive disease is a condition in which connective tissue tissues are formed between the internal organs of the abdominal cavity. Adhesive disease can develop for various reasons, including with laparoscopy, especially when it was not only of a diagnostic nature.

Causes of adhesions after laparoscopy

First of all, the commissural disease develops against a background of chronic inflammation caused by various pathogens. Infection can penetrate in many ways - non-sterile equipment, improper skin treatment or preparation (not shaving hair), and possible spread of pathogens from one place to another in case of organ damage.

If laparoscopy was originally performed with the aim of eliminating adhesions, the infection could spread both with the help of a laparoscope, and because of the increase in inflammation.

There are predisposing factors in which laparoscopy only provoked inflammation, which was already ripening due to: the use of the uterine spiral, numerous abortions, sexual infections (chlamydia, trichomoniasis and gonorrhea) provoke the adhesions of the fallopian tubes in women.

Laparoscopy could be performed due to inflammation, for example, with appendicitis, then the adhesion disease is more likely to indicate the consequences of this disease than due to laparoscopy.

Injuries, vascular ruptures during laparoscopy can in themselves lead to inflammation and it is especially dangerous to accumulate outpoured blood with the formation of hematomas. They can become infected, which is likely to lead to spikes.

It is possible that the bleeding was earlier before laparoscopy. Then it is worth taking all measures to get rid of internal hematomas. Similar hemorrhages are observed with ectopic pregnancy and ovarian apoplexy.

The removal of endometrioid growths should be done qualitatively and accurately, otherwise the introduction of such tissue in other places is fraught with a commissural disease.

If you look at the statistics, most of the causes of adhesions are associated with laparoscopic removal of the appendix, operations in the small pelvis and bowel obstruction.

Symptoms

Spikes flow without any symptoms or have a aching or pulling character lasting for a long time. If there is an "acute abdomen" - a condition in which painful sensations increase sharply and are severe in terms of pain - call an ambulance.

Other symptoms of adhesions are intestinal obstruction and infertility in women. As a rule, it is observed in the chronic course of the pathological process and proceeds in a less than symptomatic manner.

Diagnosis of adhesions

Strangely enough, the most effective diagnosis of adhesions in adhesions after laparoscopy is diagnostic laparoscopy. The most important diagnosis of this disease is to understand that ultrasound diagnosis is ineffective. If possible, it is necessary to undergo magnetic resonance imaging or computed tomography. The result may be a commissural disease and without resorting to invasive methods.

If a woman suffers from infertility and there are suspicions of spikes, the gynecologist prescribes a swab from the vagina and then laparoscopy. Before laparoscopy, hysterosalpingography can be prescribed - a study using a contrast medium that is inserted into the uterus, and then an X-ray examination is performed. This procedure allows you to establish obstruction or partial obstruction of the fallopian tubes.

Treatment of adhesions after laparoscopy

Once the location of the adhesions has been established, they begin therapy. There are conservative methods, however, only laparoscopy is effective for the so-called intermittent form of adhesions (when the pains come in sockets and patients are concerned about intestinal obstruction and discomfort in the abdominal region).

If successfully carried out medical measures for an infectious disease, prescribe anti-inflammatory and anti-allergenic drugs. This will suspend the further development of adhesions.

With the development of minor adhesions, the doctor prescribes enzyme therapy - trypsin, chymotrypsin or longidase. They will promote the resorption of small connective-tissue strands. Perhaps these drugs are enough to restore reproductive function or get rid of unwanted symptoms of adhesions.

There are other ways of treatment with the use of internal laser or magnetic-laser treatment, but it is ineffective in chronic forms of the disease.

Treatment with laparoscopy

As already mentioned, laparoscopy is most successful in combating spikes. Apply three methods of treatment:

1) Laser - laser therapy

2) Using aquadisection, when a stream of water is supplied under pressure

3) And with the help of an electric knife

The choice of method of treatment depends on the goals of laparoscopy and the features of the course of the disease. Thus, with the preventive purpose, it is possible to apply a supply of a liquid containing polymeric materials that will gradually dissolve the adhesions or prevent their formation. Read also about an adhesive disease of the abdominal cavity from another doctor.