Adhesions After Bowel Surgery: Can They Reoccur?

It is possible for adhesions to reoccur after bowel surgery. These adhesions typically form as a result of prior abdominal surgeries, infections, trauma, or internal bleeding within the abdominal cavity. Adhesions can develop between the intestines and old abdominal incisions, between loops of the intestine, or between the intestine and other abdominal structures. Regardless of the type, during surgical release, careful sharp dissection is essential to minimize injury to the bowel and prevent perforation. Surgeons must be patient and meticulous during this process, avoiding forceful separation techniques to reduce the risk of severe postoperative adhesions.

Postoperative Care and Management

In the early postoperative period, it's crucial to correct fluid and electrolyte imbalances. Patients are typically administered broad-spectrum antibiotics, including agents effective against anaerobic bacteria, such as a combination of cephalosporins with metronidazole or quinolones. Fasting is required initially to reduce gastrointestinal stress and allow the digestive system to heal. Ensuring proper drainage from the abdominal cavity is also vital during this stage.

Managing Potential Complications

Within the first one to two weeks following surgery, if a patient develops symptoms of bowel obstruction, it may indicate the formation of new adhesions due to inflammatory fluid buildup. In such cases, prompt diagnosis is important. Treatment often includes aggressive anti-inflammatory therapy, administration of somatostatin and corticosteroids, and provision of intravenous nutrition. Reoperation is generally avoided unless absolutely necessary, as repeated surgeries increase the risk of developing irreversible, life-threatening adhesions and severe infections.