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The Question of Operation and After-Care
Sometimes after an attack of inflammation in an abdominal organ such as the appendix or gall bladder, whether or not this has been treated by an operation, a person suffers from pain or from situations of dragging in the neighbourhood of the old disorders. These symptoms are the result of adhesions. The healthy abdomen has a smooth internal lining, and the abdominal organs have smooth coverings, the result being that the organ can move easily and, within ordinary limits, quite freely over one another and on the abdominal walls. Should inflammation occur, however, these smooth surfaces become roughened and may actually be glued together. The material which roughens and may bind them together is, to begin with, soft, but it firms up and acquires the nature of scar tissues. It is this piece of newly formed tissue attaching an organ to another one or to the abdominal wall which is known as an adhesion. Most operations within the abdomen are followed by the formation of adhesions. These may or may not cause future trouble.
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Inflammatory adhesions B and C unite to the appendix A and small intestine D; and to the fallopian tube E. The membrane on the left of the appendix is a normal fold of the peritoneum.

Palpation of the lower right abdominal quadrant will generally reveal the location tender.

Adhesions do not occur only in the abdomen; they may occur wherever, in the body, there is a surface to which any other can be attached: in the pleural cavity, in the heart, in the eye, about a joint, and so on. One effect of adhesions is to limit movements, as, for example, often occurs in a joint which has been sprained. Adhesions about the bowels may cause kinking of the tube or an adhesion in the form of a band or cord may tend to compress it. In this way may be explained the constipation, the dragging sensations, the distension of the bowel by gases, and the pains which often affect people who have had Inflammatory trouble in the abdomen.
Sometimes an adhesion will cause serious obstruction of the bowel. Adhesions round the joints may be stretched or broken down, and manipulations to effect this are often per formed on the joints and elsewhere, but it is often necessary to perform a cutting operation in order to deal effectively with them.