Adhesions are one of the most feared after effects of abdominal surgery, although we can be thankful that serious problems with them are relatively rare. Last year I posted several times (between February 18 and June 23 2011) about various aspects of post-surgery adhesions: you can find these posts by searching this site for “adhesions” or by starting at this link.
What are adhesions?
Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connects tissues not normally connected. (Wikipedia) Almost all abdominal and often other surgery results in adhesions forming, but it is fairly unusual for them to bother us.
Because this subject remains one of the top subjects that brings readers to this blogsite, and as it is one of the most common causes of grief after infant pyloric stenosis (“PS”) surgery in particular, I return to it here. Read some of the different ways people have been troubled by adhesions, as registered on the web.
“He is 9 years old”
My son had PS surgery when he was 2 weeks old. He is 9 years old now and his scar is tucked way in and he complains of pain and pulling. I took him to pediatrician and she referred him to pediatric surgeon. The surgeon knew exactly what was wrong, he had a hernia and tearing from the pulling of the scar because it was attached to his abdominal wall and as his belly grew it got worse and pulled more, and also the scar tissue prevented his ab muscles from growing together. He just had surgery on Tuesday… and they detached the scar from the ab wall, repaired the hernia, and attached the muscles as they are supposed to be.
The surgery went well, but recovery is pretty tough. He stayed overnight at hospital and we came home the next evening. He is in a lot of pain and has a hard time even walking to the bathroom. I know it will take some time to heal and feel better, but he is going to have a better quality of life now without scar pain.
If you have insurance this procedure is usually covered because it is a health concern and NOT for cosmetic reasons. So a pediatric surgery is the best way to go and not a plastic surgeon.
The incision now sits flat on the tummy and isn’t tucked way in.
“It shrinks and hurts like hell”
I was a first child and had PS as well. Doctors always looked at me funny when I told them that. I have an almost 5 inch scar that has is bulky and is such a mass that it has attached itself to my diaphragm. I am going to a general surgeon in a couple of weeks to get it checked out and possibly reduced a bit…
Mine bothers me when I exercise because I breathe heavily, so my diaphragm moves a lot – then it stretches the scar tissue and tears. Once I have been exercising for a while as long as I keep it up regularly it doesn’t shrink again and I’m good. But if I stop it shrinks and hurts like hell when I start up exercising again.
“I have always had … intestinal distress”
I am 45 years old and had surgery for PS at about two weeks old. The reason I went looking for more info on PS online is that I have always had what I call intestinal distress and wonder if that is common. The only other complication I have had is 5 years ago when I had emergency gall bladder surgery. I had so much scar tissue that my gall bladder, bile ducts, etc. were basically cemented together which made the surgery last much longer than anticipated.
“Thinking I had a gall bladder attack”
I am 42 and my whole life had digestive problems. I am male, and had the pyloric stenosis operation a few days old. Only just this week, after thinking I had a gall bladder attack did I finally – after decades of basically being told I am crazy whenever I went in for stomach pain – did a doctor tell me I might have adhesions. I was actually in the hospital thinking I had a gall bladder attack, but when I explained to the doctor that as long as I remember I have had pains under the scar from the surgery and throughout my intestines… worsening as I got older – did it seem to click. Still have to see more specialists and determine things… but it is great to finally perhaps have an answer.
“You have developed some major adhesions”
I’m a bit worried about a scar on my stomach. When I was a baby (I’m 21 now) my stomach was operated on (pyloric stenosis) and so I have a scar about 5 cm long to the side and above my navel.
Whenever I press on the scar it really hurts. It also feels very hard under the scar and around it, it also feels lumpy and sometimes I get stabbing pains.
Is this something I should look into, or is it normal?
Reply 1 –
My advice is to use a gentle cream and to massage slowly; after some time you won’t feel anything any more and the scar will become quite nice.
Reply 2 –
It is very well possible that you have developed some major adhesions to the inside wall of your belly. As a result the tissue which is normally more or less flexible inside the abdomen has now been ties to that wall. That’s what you are feeling when you press in.
If you’ve got more problems than just these I’d advise you to ask your GP /MD to have a look and feel. A physical check will I trust set your mind at ease.
“Not being taken seriously”
My son who is now 18 was operated on for pyloric stenosis when he was 2 weeks old.
Now his scar regularly bothers him: it feels very tight and makes him feel unwell, even giving him nausea.
We have already been to the MD/GP a couple of times but get the feeling that his problems are not being taken seriously.
“I will eventually need another surgery”
My scar is also about 4 inches across and on the right side right under my diaphragm. I have been told that the surgery was supposed to be a permanent fix but that also as I age and develop more scar tissue, I will eventually need another surgery to remove scar tissue and release the muscle and fat that has grown on top of and on the scar. I also tend to have spasms and a pulling sensation sometimes during/ after exercise, eating, or just randomly. Mine is not an intense pain at all though: just kind of a weird feeling. Whenever I get the stomach flu or drink a little too much I tend to have trouble ending the vomiting unless I take phenigran or another anti- nausea medication. I also have irritable bowel syndrome so I wonder if there’s any correlation there?
“11 years and has intense scar pain”
My son had PS at 6 weeks, and had 2 surgeries after that (6 mo, 9 mo). Doctor thought he had a hernia at the site, but it turned out to be excessive scar tissue – both times. He’s now 11 years and has intense scar pain when the site is touched (even brushed) described as an “ice pick”. And yes, he tends to get stomach flu-like symptoms very often. Has anyone looked for treatment for the pain that worked, but would be endurable – deep massage would not be an option I think.
“I went to a doctor”
I have the scar on my right side as well. I’m also unable to do any major ab workout without tears due to the scar. I went to a doctor and he kind of brushed it off and said there was nothing he could do.
Although I have avoided identification of the sources, web references are available on request.
These are just a very small sample of the complaints and experiences people have published online. And no doubt they are just the tip of an iceberg. I am certain that like me, everyone who is alive today due to PS or other surgery is grateful their life was saved and for safe and effective medical skills – as is every parent whose child has been saved from an agonising death by starvation.
In publishing these Comments, I want to –
(1) help inform and reassure those affected by continuing post-surgical discomfort or distress that they are far from alone, and that given the right doctor or therapy, help (or at least some relief) is available;
(2) remind interested readers again that routine PS surgery is not without real and sometimes significant consequences; and
(3) raise the awareness of the alternative of medical therapy which is possible for the majority of PS babies – provided the condition is identified in time and the medical people concerned are not closed to this option (see the posts on “medical treatment” on this and other sites).
In one of my next posts I would like to relate the story of somebody whose struggle with adhesions after PS surgery has continued through their life and several surgical interventions to manage the effects.