Which finding increases the risk of enterotomy due to adhesions during laparoscopy?

• A. Previous abdominal surgery
• B. No prior abdominal procedures
• C. Pregnancy
• D. Recent upper respiratory infection

Answer: (A)

Adhesions from prior abdominal surgery increase the risk of enterotomy during laparoscopy because scar tissue can bind loops of intestine to the abdominal wall or to other organs, altering normal anatomy. When the abdomen is entered or adhesions are encountered, there’s a real chance of injuring a loop of bowel that is stuck or tethered in an unexpected position. Prior abdominal surgery is the strongest risk factor for these adhesions, so it raises the likelihood of enterotomy during laparoscopic access or dissection. Not having had abdominal procedures means fewer adhesions; pregnancy doesn’t create adhesions, and a recent upper respiratory infection is unrelated to intra-abdominal adhesions.