Medicolegal consequences of postoperative intra-abdominal adhesions.
Postoperative adhesions are an almost invariable consequence of abdominal and pelvic surgery. Their most important morbidity is small-bowel obstruction, but other sequelae include female infertility and dyspareunia and increased risk of visceral injury at subsequent laparotomy or laparoscopy. Whether chronic abdominal pain is truly a consequence of adhesions is debatable, although it is likely to be accepted as an entity by both patients and their legal advisors. Of 14 successful claims dealt with by a British medical defence organization, 5 were for perforations after laparoscopic division of adhesions, 2 for adhesions after laparoscopic surgery, 1 for infertility as a result of adhesions and 6 for delayed diagnosis of obstruction. General practitioners, surgeons and gynaecologists need to be aware of the increasing burden of medicolegal claims arising from these complications.
Ellis
H
H
Human Sciences Research, King's College London, Hodgkin Building, Guy's Hospital Campus, London SE1 1UL, UK.
D015746:Abdominal Pain / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007813:Laparotomy / Q000009:adverse effects*; D019300:Medical Errors / Q000331:legislation & jurisprudence*; D000267:Tissue Adhesions / Q000209:etiology*; D006113:United Kingdom