Large scrotal hernia: a complicated case of mesh migration, ascites, and bowel strangulation

A 30-year-old male with 1 1/2-year history of an asymptomatic, large, reducible right indirect scrotal hernia presented to the emergency department complaining of a 2-week history of increasing abdominal distension and daily emesis. He had recently undergone an emergent exploratory laparotomy in which his asymptomatic hernia was repaired with a mesh plug from an intra-abdominal approach. The mesh plug subsequently migrated into the patient's scrotum resulting in a strangulating bowel obstruction. This paper discusses a serious complication that may result from inappropriate use and placement of a mesh plug and our approach to correct the situation utilizing a bioabsorbable mesh prosthesis.