Lapis ISSN 2398-2969

Abdomen: adhesion formation - post-surgical

Contributor(s): Lesa Thompson, Robert Lawrie, Lesa Longley, Vicki Baldrey

Introduction

  • Rabbits are well known for their propensity to form adhesions after surgery in the coelomic cavity.
  • They are widely used as animal models for research on intra-abdominal adhesions.
  • Cause: inflammation of tissues within abdominal cavity.
  • Signs: abdominal discomfort, lethargy, reduced appetite/anorexia, reduced fecal output/diarrhea.
  • Diagnosis: clinical assessment, radiography, ultrasound, abdominal fluid, surgery or endoscopy.
  • Treatment: surgical resection.
  • Prognosis: depends on the location of the adhesions.

Presenting signs

  • May be acute or chronic in onset.
  • Reduced appetite.
  • Lethargy.
  • Reduced fecal output (gastrointestinal stasis).
  • Chronic diarrhea.
  • Abdominal discomfort.
  • Bruxism.

Acute presentation

  • Anorexia.
  • Gastrointestinal stasis with cessation of fecal output.
  • Abdominal distension.
  • Abdominal pain.
  • Bruxism.

Cost considerations

  • Repeated surgery to attempt resolution may be expensive.

Special risks, eg anesthetic

  • Prolonged surgery time may be associated with more extensive handling of abdominal viscera, thus increasing the risk of post-operative adhesion formation.

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Guzman D S M, Graham J E, Keller K et al (2015) Colonic obstruction following ovariohysterectomy in rabbits: 3 cases. J Exotic Pet Med 24 (1), 112-119 VetMedResource.
  • Conze J, Junge K, Weiss C et al (2008) New polymer for intra-abdominal meshes--PVDF copolymer. J Biomed Mater Res B Appl Biomater​ 87 (2), 321-328 PubMed.
  • Mashhadi M T R, Shojaian R, Tabatabaee A et al (2008) Effects of peritoneal exposure to povidone iodine, heparin and saline in post surgical adhesion in rats. J Res Med Sci 13 (3), 135-140 ResearchGate.
  • Cohen P A, Aarons G B, Gower A C et al (2007) The effectiveness of a single intraperitoneal infusion of a neurokinin-1 receptor antagonist in reducing postoperative adhesion formation is time dependent. Surgery 141 (3), 368-375 PubMed.
  • Lang R A, Grüntzig P M, Weisgerber C et al (2007) Polyvinyl alcohol gel prevents abdominal adhesion formation in a rabbit model. Fertil Steril 88 (4 Suppl), 1180-1186 PubMed.
  • Karabulut B, Sönmez K, Türkyilmaz Z et al (2006) Omentum prevents intestinal adhesions to mesh graft in abdominal infections and serosal defects. Surg Endoscopy 20 (6), 978-982 PubMed.
  • Yeo Y, Highley C B, Bellas E et al (2006) In situ cross-linkable hyaluronic acid hydrogels prevent post-operative abdominal adhesions in a rabbit model. Biomaterials 27 (27), 4698-4705 PubMed.
  • Avital S, Bollinger T J, Wilkinson J D et al (2004) Preventing Intra-Abdominal Adhesions With Polylactic Acid Film: An Animal Study. Dis Colon Rectum 48 (1), 153-157 PubMed.
  • Tittel A, Treutner K H, Titkova S et al (2001) New adhesion formation after laparoscopic and conventional adhesiolysis: a comparative study in the rabbit. Surg Endoscopy 15 (1), 44-46 PubMed.
  • Rodgers K, Cohn D, Hotovely A et al (1998) Evaluation of polyethylene glycol/polylactic acid films in the prevention of adhesions in the rabbit adhesion formation and reformation sidewall models. Fertil Steril 69 (3), 403-408 PubMed.
  • Rodgers K, Girgis W, diZerega G S et al (1990) Intraperitoneal tolmetin prevents postsurgical adhesion formation in rabbits. Int J Fert 35 (1), 40-45 PubMed.
  • Steinleitiner A, Lambert H, Kazensky C et al (1990) Reduction of primary postoperative adhesion formation under calcium channel blockade in the rabbit. J Surg Res 48 (1), 42-45 PubMed.

Other sources of information

  • Varga M (2014) General Surgical Principles and Neutring. In: Textbook of Rabbit Medicine. 2nd edn. Butterworth-Heinemann, Oxford. pp 425-434.
  • Saunders R (2013) Exploratory Laparotomy. In: Manual of Rabbit Surgery, Dentistry and Imaging. Eds: Harcourt-Brown F & Chitty J. BSAVA. pp 157-171.
  • Varga M (2013) Basic Principles of Soft Tissue Surgery. In: Manual of Rabbit Surgery, Dentistry and Imaging. Eds: Harcourt-Brown F & Chitty J. BSAVA. pp 123-137.
  • Jenkins J R (2012) Gastrointestinal diseases. In: Ferrets, Rabbits, and Rodents: Clinical Medicine & Surgery. 3rd edn. Eds: Quesenberry K E & Carpenter J W. Saunders, St Louis, Missouri. pp 193-204.
  • Jenkins J R (2012) Soft Tissue Surgery. In: Ferrets, Rabbits, and Rodents: Clinical Medicine & Surgery. 3rd edn. Eds: Quesenberry K E & Carpenter J W. Saunders, St Louis, Missouri. pp 269-278.


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