[Postoperative intraperitoneal adhesions]

Almost any surgical procedure in the abdomen inevitably produces adhesions. During this century a large number of papers have been published on this subject. A great amount of experimental studies have been carried out, and a lot of laboratory animals have been sacrificed, in order to find preventive measures against adhesions. A general agreement exists concerning the etiology and pathogenesis of adhesions, but currently no methods have been found to prevent adhesions which could be proven by controlled clinical trials. However, recent animal studies have given rise to a certain optimism. In these experimental models adhesions could effectively be prevented by topical tissue plasminogen activator without side effects. The use of the gastrointestinal prokinetic agent Cisaprid and free radical scavengers have also shown positive results. Intestinal or mesenterial plication procedures, described in several case control studies, might have a place in the treatment of intestinal obstruction due to extensive adhesions under certain circumstances.