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Peritoneal Adhesions J031

Last amended 
4 January 2016
Current RMA Instruments:
Reasonable Hypothesis SOP
3 of 2016
Balance of Probabilities SOP
4 of 2016
Changes from previous Instruments:

SOP Bulletin 187

ICD Coding:
  • ICD-9-CM Codes: 560.81, 568.0, 614.6
  • ICD-10-AM Codes: K56.5, K66.0, N73.6, N99.4
Brief description

The peritoneum is a continuous transparent membrane which lines the abdominal and pelvic cavity and covers the abdominal and pelvic organs.  Peritoneal adhesions are bands of fibrous tissue that join abdominal / pelvic organs to each other or the abdominal/pelvic wall. Adhesions can develop rapidly after damage to or inflammation of the peritoneum.

Confirming the diagnosis

Adhesions are confirmed by abdominal/pelvic surgery, including laparoscopy.  They may be asymptomatic but can also cause bowel obstruction and abdominal or pelvic pain.  They can be suspected clinically, but definitive diagnosis requires visualisation at surgery.

The relevant medical specialist is a general surgeon or gynaecologist.

Additional diagnoses that are covered by SOP
  • Abdominal adhesions
  • Pelvic adhesions
Clinical onset

Clinical onset will at the time of diagnosis for asymptomatic adhesions.  For symptomatic adhesions, once the diagnosis has been confirmed, onset may be backdated to the time of onset of relevant symptoms.

Clinical worsening

The only SOP worsening factor is for inability to ontain appropriate clinical management.  Asymptomatic adhesions require no treatment.  Surgery may be required to treat symptomatic adhesions.  Appropriate clinical management in someone with adhesions may also include taking measures at the time of any abdominal/pelvic surgery to minimise formation of new adhesions.