Pathophysiology of adhesions.

Formation of intraperitoneal adhesions after abdominal or pelvic surgery is a very common phenomenon. Although there is no universally accepted definition, they are bridges of scar tissue between the various organs of the peritoneal cavity as a result of a local repair process excessively. Adhesions can be congenital or acquired as a local inflammatory process. Some adhesions can be asymptomatic, but many of them can cause severe complications such as abdominal or pelvic pain, female infertility, and intestinal obstruction. Physicians and patients should be informed of the possibility of postoperative intraperitoneal adhesions and this possibility should be mentioned in the informed consent signed by the patient. The formation of adhesions has multiple proinflammatory mechanisms involved, many with a pathophysiology still incomplete understood. Laparoscopic procedures do not diminish much the possibility of developing postoperative adhesions.Diagnostic imaging is quite uncertain, and the possibilities of preventing with a poor final result. The use of correct surgical technique and avoidance of traumatic intraperitoneal organs maneuvers may help reduce postoperative adhesions incidence.