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Gallagher KC, Pinzon-Guzman C, Pierce RA, Tan MCB. Small Bowel Obstruction Caused by Bezoar Formation Around Intraluminal Hernia Mesh. Am Surg 2022; 88:1904-1906. [PMID: 35451332 DOI: 10.1177/00031348221086788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a case report wherein a 55-year-old female presented to our clinic with chronic nausea, vomiting, and dehydration in the setting of a complex past surgical history, including laparoscopic incisional hernia repair in 2007 with intraperitoneal TiMeshTM. She then developed chronic nausea and vomiting and was hospitalized numerous times for dehydration. Due to her ongoing symptoms, she was taken to the operating room for exploration. A large, firm, mobile mass was identified within a loop of small bowel and was found to be a large bezoar firmly attached to a piece of intraluminal mesh. She progressed well postoperatively and, on outpatient follow-up, her pre-operative abdominal symptoms had completely resolved. To our knowledge, this is the first reported case of gallstone-like bezoar formation around an intraluminal hernia mesh causing small bowel obstruction and chronic abdominal pain.
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Affiliation(s)
- Kathleen C Gallagher
- Section of Surgical Sciences, 5718Vanderbilt University Medical Center, Nashville, TN, USA
| | - Carolina Pinzon-Guzman
- Section of Surgical Sciences, 5718Vanderbilt University Medical Center, Nashville, TN, USA
| | - Richard A Pierce
- Section of Surgical Sciences, 5718Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marcus C B Tan
- Section of Surgical Sciences, 5718Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Ingram Cancer Center, 12328Vanderbilt University Medical Center, Nashville, TN, USA
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2
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Leach JR, Manoukian B, Stewart L. Mesh on the move: a case report of total transmural surgical mesh migration causing bowel obstruction. Clin J Gastroenterol 2020; 14:136-140. [PMID: 33241525 DOI: 10.1007/s12328-020-01291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 10/28/2020] [Indexed: 08/30/2023]
Abstract
We present the case of a 60-year-old man with a complex medical history, presenting to the hospital with generalized weakness and found to be markedly hyperglycemic. Early in the patient's hospital course, he developed abdominal pain and was found to have a small bowel obstruction secondary to intraluminal migrated surgical mesh entrapped in the terminal ileum. The bowel obstruction was relieved surgically with uncomplicated mesh removal and ileocecectomy. Surgical mesh migration is a relatively rare complication of hernia repair and abdominal wall reconstruction, and intraluminal mesh migration is an even more rare variant. Our case demonstrates key clinical and imaging features and serves as an important example of how such cases may present.
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Affiliation(s)
- Joseph Ryan Leach
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. .,Department of Radiology, San Francisco Veterans Affairs Medical Center, 4150 Clement St, Building 200, Room 2D-008, San Francisco, CA, 94121, USA.
| | - Bryan Manoukian
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Lygia Stewart
- Department of Surgery, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
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3
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Lee Y, Bae BN. Transmural Mesh Migration From the Abdominal Wall to the Rectum After Hernia Repair Using a Prolene Mesh: A Case Report. Ann Coloproctol 2020; 37:S28-S33. [PMID: 32674553 PMCID: PMC8359694 DOI: 10.3393/ac.2020.04.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/19/2020] [Indexed: 12/29/2022] Open
Abstract
Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore, the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh (Ethicon) from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.
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Affiliation(s)
- Yujin Lee
- Department of General Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Byung-Noe Bae
- Department of General Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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4
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Manzini G, Henne-Bruns D, Kremer M. Severe complications after mesh migration following abdominal hernial repair: report of two cases and review of literature. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2019; 8:Doc09. [PMID: 31275799 PMCID: PMC6545489 DOI: 10.3205/iprs000135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Migration of mesh after ventral and incisional hernia repair is a rare but well described complication. The aim of our work is to present two cases of mesh migration after incisional hernia repair and to review the current literature. Methods: We describe the two cases of mesh migration that occurred at our department. Additionally, we performed a systematic literature search. Results: In both cases we observed a mesh migration with formation of an entero-cutaneous fistula that required surgical therapy. In the literature search we found a total of 16 publications dealing with mesh migration after incisional (n=14) and ventral hernia (n=2) repair in adult patients (15 case reports and one retrospective study). In 9 out of 15 patients (54%) who presented with mesh migration or erosion, a polypropylene mesh was responsible for this complication. Conclusions: Mesh migration after abdominal hernia repair is rare, the only available retrospective study reports a rate of 2.7%. The ability of polypropylene mesh to migrate into hollow viscera is well known and confirmed both by our data and the results of the literature review. As the incidence of mesh erosion/migration is significantly lower than the recurrence rate after hernia repair without mesh, up to now, no better alternative exists for the treatment of abdominal wall hernia than mesh augmentation.
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Affiliation(s)
- Giulia Manzini
- Department of General and Visceral Surgery, University Hospital of Ulm, Germany
| | - Doris Henne-Bruns
- Department of General and Visceral Surgery, University Hospital of Ulm, Germany
| | - Michael Kremer
- Department of General and Visceral Surgery, University Hospital of Ulm, Germany.,Department of General and Visceral Surgery, Kantonsspital Aarau, Switzerland
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5
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Patel R, Reid TH, Parker SG, Windsor A. Intraluminal mesh migration causing enteroenteric and enterocutaneous fistula: a case and discussion of the 'mesh problem'. BMJ Case Rep 2018; 2018:bcr-2017-223476. [PMID: 29666083 DOI: 10.1136/bcr-2017-223476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The use of synthetic mesh in the abdominal compartment has recently become a topic of debate as high profile public cases have called into question their safety. Several case reports have demonstrated significant complications due to intra-abdominal mesh. Furthermore, some studies have suggested that the rates of these severe complications are underestimated. We present the case of a patient who developed an enteroenteric and enterocutaenous fistulae, an abdominal wall collection and an intraperitoneal inflammatory mass from intraluminal migration of a synthetic mesh inserted during laparoscopic incisional hernia repair. We discuss the considerations and complications of using synthetic mesh for ventral hernia repair and discuss the scientific evidence behind the increasingly apparent 'mesh problem'.
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Affiliation(s)
- Reeya Patel
- General Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Thomas H Reid
- General Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sam G Parker
- General Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Alistair Windsor
- General Surgery, University College London Hospitals NHS Foundation Trust, London, UK
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Cunningham HB, Kukreja S, Huerta S. Mesh migration into an inguinal hernia sac following a laparoscopic umbilical hernia repair. Hernia 2018; 22:715-720. [PMID: 29605843 DOI: 10.1007/s10029-018-1759-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 03/10/2018] [Indexed: 11/25/2022]
Affiliation(s)
- H B Cunningham
- Surgical Service (112), VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA
| | - S Kukreja
- Surgical Service (112), VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA
| | - S Huerta
- Surgical Service (112), VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX, 75216, USA.
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7
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Tsapralis D, Vasiliades G, Zaxou Z, Delimpaltadaki M, Margetousakis TH, Papadakis H, Machairas A, Misiakos EP. Bowel obstruction secondary to migration of a Ventralex mesh: report of a rare complication. Hernia 2018; 22:711-714. [PMID: 29372340 DOI: 10.1007/s10029-017-1720-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 12/27/2017] [Indexed: 11/24/2022]
Affiliation(s)
- D Tsapralis
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - G Vasiliades
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - Z Zaxou
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - M Delimpaltadaki
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - T H Margetousakis
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - H Papadakis
- Department of General Surgery, General Hospital/Health Center of Ierapetra, Ierapetra, Crete, Greece
| | - A Machairas
- 3rd Department of General Surgery, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Chaidari, Athens, Greece
| | - E P Misiakos
- 3rd Department of General Surgery, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Chaidari, Athens, Greece.
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