ReviewAbdominal adhesions: A practical review of an often overlooked entity

•Abdominal adhesions commonly form after intra-abdominal surgery, radiation, and inflammatory processes.•In a subset of patients, adhesions lead to problematic symptoms such as abdominal pain, bloating, and bowel obstruction.•Symptomatic adhesions (i.e. adhesive disease) can be diagnostically elusive and thus under-recognized by physicians.•Adhesive disease often requires multimodal evaluation; in select patients, operative intervention can be diagnostic and therapeutic.

Formation of intra-abdominal adhesions is a common consequence of abdomino-pelvic surgery, radiation therapy, and inflammatory processes. In a small but clinically significant proportion of patients, adhesive disease may develop, wherein adhesions lead to a variety of chronic symptoms such as abdominal distension, pain, nausea, and abnormal bowel movement pattern which can be daily, intermittent, or episodic. Due to the chronic and troublesome nature of these symptoms, adhesive disease may be life-altering in many patients, particularly when not recognized and appropriately addressed, as is the case not infrequently. In addition, there is a paucity of literature regarding the evaluation and management of patients with suspected abdominal adhesive disease. Therefore, in this concise review, we provide a clinically practical synopsis of the etiopathogenesis, symptoms, differential diagnosis, evaluation, and treatment of abdominal adhesive disease.