Blood and intraperitoneal adhesion formation in the rat

The pathogenesis of adhesion formation is not completely understood, though it is largely accepted today that fibrous adhesions result from organisation of fibrinous intraperitoneal deposits caused by inflammation or injury to serosal surfaces of abdominal or pelvic organs. Much confusion exists as to the significance and role of intraperitoneal blood in the process of adhesion formation. In an attempt to find an answer to such a basic and fundamental question, we investigated the role of plasma and blood in this process in the rat, with or without relation to induced injury to the uterine serosa. The amount and extent of adhesion formation was evaluated in ten rats with induced haemoperitoneum and ten with plasma in the peritoneal cavity, and the results compared with those of ten controls. The effect of trauma to the uterine serosa was evaluated as well, and compared to controls. Our results show a major role of injury to the serosa in postoperative adhesion formation and also suggest that the mere presence of blood in the peritoneal cavity predisposes to the formation of adhesions.