Like sand in your shoes: are the nerve fibers in peritoneal adhesions to blame for chronic abdominal pain after surgery?

There is an analogy: "What wears you out is not the mountain ahead, but the grain of sand in your shoes".This captures the insidious and lingering discomfort caused by specks of sand.Similarly, postoperative peritoneal adhesions are associated with pain, posing persistent challenges following abdominal surgery.Arising from abnormal healing of the peritoneum following injury, peritoneal adhesion is defined as abnormal adhesion between visceral organs or between organs and the abdominal wall, which triggers a multitude of severe complications, including intestinal obstruction, female infertility, and abdominal pain.Due to these various impacts, peritoneal adhesions impose a substantial societal economic and personal wellbeing burden. 1 Despite extensive research, our understanding of peritoneal adhesion complications, especially peritoneal adhesion-associated chronic abdominal postoperative pain (PACP), remains far from comprehensive.