The Pathogenesis of Peritoneal Adhesions

Abstract

Serosal adhesions were studied in albino rats of both sexes following intraperitoneal injection of colloidal silica. Peritoneal surfaces and adhesions of the liver were examined at intervals of from 1 min. to 6 months postinjection. By 1 min. postinjection, numerous silica particles were present within and adsorbed to surfaces of mesothe-lial cell microvilli. Three phases were discernible in the evolution. of fibrous adhesions. The 1st phase (0 time-7 hr.) involved degeneration and desquamation of mesothelial cells. In the 2nd phase (7 hr.-lO days) fibrin deposition on exposed basement membranes led to formation of fibrinous adhesions. Transformation of fibrinous into fibrous adhesions comprised phase 3 (10 days-1 month). Under these experimental conditions desquamation of mesothelial cells appeared to be the critical event in adhesion formation, and adhesions apparently developed only when 2 denuded surfaces were in apposition.