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Adhesions between liver surface and diaphragm after Fitz-Hugh-Curtis syndrome

Adhesions or adhesions , medical adhesions that form between organs or tissues which are not normally associated with each other. A strand of scarring that occurs frequently in the abdominal cavity is also called a bride , and the term " abdominal adhesions" is also used colloquially. The term synechia is also used.


Tender adhesions in the Douglas space in endometriosis

Occasionally adhesions are congenital, but usually they are a result of damage ( lesions ) of the peritoneum ( peritoneum ) as part of a surgical procedure or inflammation in the abdomen. Also, endometriosis often leads to such bonds.


Adhesions after appendectomy

Adhesions essentially consist of connective tissue and are partially permeated by blood vessels. These are mostly vessels that are lined with endothelium , but have no intima . Like the peritoneum, adhesions are coated with mesothelial cells .


The classification of the American Fertility Society (today: American Society for Reproductive Medicine ) has established itself for the staging of adhesions . The adhesions in the area of ​​the fallopian tubes and ovaries are assessed according to a point scheme from 0 to 16 per fallopian tube or ovary.

American Fertility Society (AFS) staging of adhesions

AFS category AFS score (sum of points)
minimal (minimal) 0-5
mild (light) 6-10
moderate (medium) 11-20
severe (difficult) 21-32

Consequences and Therapy

Adhesions can be the cause of numerous complaints. For example, if the internal female genitals are affected, it can lead to infertility , sexual dysfunction and pain in the lower abdomen. Adhesions in the intestine usually lead to intestinal disorders, which under certain circumstances can lead to an intestinal obstruction.

The only possible therapeutic method is surgical severing of the adhesions ( adhesiolysis ). However, the success of the treatment is almost wiped out by the high rate of recovery after adhesiolysis.

Adhesion prophylaxis

Effective liquid adhesion are Ringer's lactate solution , or because these sugar-like substance is degraded more slowly, a 4% icodextrin solution. These solutions are used as intraoperative irrigation fluid and as a postoperative instillate in gynecological and visceral surgery . Another effective barrier method is the introduction of a gel made from polyethylene oxide and sodium carboxymethyl cellulose.

Adhesion in other lay medical parlance

The verb grown is sometimes referred to in malformed used or deformed, or in connection "that grows together (or not)" in connection with the hope of a change of an emerging deformity in the course of another body growth, such as deformation of the head (flattened head in babies) or in connection with knock knees or bow legs .


  • Richard Kessing: Complications of Postoperative Adhesions - Strategies for Prevention . LinguaMed Verlag, Neu-Isenburg 2006.
  • RL De Wilde, HR Tinneberg, M. Korell: Postoperative adhesions in gynecology. Verlag ME, Much 2004, ISBN 3-9808075-5-X .

Individual evidence

  1. ^ American Fertility Society : The AFS classification of adnexal adhesions, distal tube occlusions, tube occlusions secondary to tubal ligation, tubal pregnancies, Muellerian anomalies and intrauterine adhesions. In: Fertil Steril . 1988; 49, pp. 944-955. PMID 3371491 .
  2. Adhesions - What are adhesions? | University Women's Clinic Kiel