What is a Frozen Abdomen? - Meaning, Symptoms, Causes, Treatment

What is a Frozen Abdomen?

A wound dehiscence is a dangerous postoperative event that occurs between 0.5 to 3% of the time following the primary closure of an incision made for a laparotomy. It is an abrupt failure of the wound-healing process that is caused by a mechanical factor. The term "intended open abdomen" was just recently used, and both clinical entities (also known as "postoperative open abdominal wall") share similar pathophysiological and clinical processes. Although early repair is the goal, a major percentage of patients may develop adhesions between the abdominal viscera and the anterior abdominal wall, a condition commonly referred to as "frozen abdomen," making delayed wound closure the only feasible option. 

Frozen Abdomen Meaning

The term "frozen abdomen" refers to a medical problem that can arise as a consequence of recurrent surgical removal of fibrous bands in the abdomen, which can lead to the formation of scar tissue that prevents other surgical procedures from being performed. In severe situations, these bands can clog the intestines, impair fertility, and strangle the bowels; therefore, they must be removed.

Symptoms of Frozen Abdomen

The majority of adhesions do not result in any symptoms at all. However, abdominal adhesions can bend the intestines like a garden hose when they form. Blockage may prevent waste, food, fluids, and air from passing through the body. You might notice symptoms such as:

• A severe ache in the abdomen region.
• Bloating.
• Nausea and throwing up.

Causes of Frozen Abdomen

The most frequent reason for abdominal adhesions is abdominal surgery. Surgical adhesions are more likely to result in symptoms and risks than those induced by other factors. After surgery, even years later, clinical signs and complications can appear at any time.

Adhesions can be caused by a variety of conditions, including those involving inflammation or infection in the abdominal region. Some examples of these diseases and infections are Crohn's disease, endometriosis, PID, diverticular disease, and peritonitis.

Abdominal adhesions can also be caused by other medical interventions, such as the use of peritoneal dialysis for a prolonged period of time to treat renal failure or radiation therapy for the treatment of cancer.

Treatment of Frozen Abdomen

There have been trials of non-invasive treatments, but none of them have shown to be reliably beneficial. Surgery is only used in individuals who have failed to react to non-surgical treatments because it only offers transient relief. Patients who have significant scarring that develops a bowel obstruction and puts the bowels at risk of being strangled or necrotized are often immediately operated on to minimize the risk of mortality. However, in some cases frozen abdomen only presents itself as pain; in these cases, a diagnosis of the frozen abdomen and subsequent surgical recommendation cannot be made until other potential causes of the discomfort, such as gallbladder illness, have been ruled out.

The fundamental objective of "frozen abdomen" surgical care is to access the peritoneal cavity through lateral incisions, away from the granulating tissue, to avoid intestinal trauma and contamination of the surgical site, which puts the use of mesh in danger. Additionally, the degree of intestinal resection should be maintained to a minimum in more complex cases of enteroatmospheric fistulae if it is essentially inevitable in order to prevent the development of short bowel syndrome.