Bordoni Bruno, Girgenti Gregory T, Escher Allan R
Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA.
Anesthesiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Cureus. 2023 Aug 7;15(8):e43092. doi: 10.7759/cureus.43092. eCollection 2023 Aug.
Peritoneal adhesions are an unwanted and frequent event following abdominal surgery, with a response rate that can reach 100%. The adhesions can be symptomatic, becoming a source of pain and discomfort for the patient, or asymptomatic, with possible chronic or acute visceral dysfunction. The article reviews what the diagnostic strategies are and discusses what could be the causes that lead to chronic pain in the presence of adhesions. The text reports the knowledge of the literature on the manual treatment of adhesions and illustrates possible symptoms that are not easily recognized by the clinician. To conclude, the article proposes osteopathic manual approaches derived from clinical experience and from what has been explained about the formation of peritoneal adhesions. Research must make further efforts to identify not only the causes triggering the formation of peritoneal neogenesis but also seek the most appropriate non-invasive treatments to help the patient.
腹膜粘连是腹部手术后常见的不良现象，发生率可达100%。粘连可能有症状，成为患者疼痛和不适的来源，也可能无症状，但可能导致慢性或急性内脏功能障碍。本文回顾了诊断策略，并讨论了粘连存在时导致慢性疼痛的可能原因。文中报告了关于粘连手法治疗的文献知识，并阐述了临床医生不易识别的可能症状。最后，本文提出了基于临床经验以及腹膜粘连形成机制的整骨手法治疗方法。研究必须进一步努力，不仅要确定引发腹膜新生的原因，还要寻找最合适的非侵入性治疗方法来帮助患者。
