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Migrating mesh mimicking colonic malignancy.

Peter Ojo1, Alissa Abenthroth, Paul Fiedler

  • 1Department of Surgery, Hospital of Saint Raphael, New Haven, Connecticut 06511, USA.

The American Surgeon
|January 16, 2007
PubMed
Summary

Prosthetic mesh plugs rarely migrate after inguinal hernia repair. This case report details a migrated mesh plug mimicking a colonic neoplasm, highlighting a rare but serious complication.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Surgery

Background:

  • Prosthetic mesh is standard for hernia repair, significantly reducing recurrence rates.
  • Despite mesh use, recurrence remains a complication, with rare instances of mesh migration reported.
  • Inguinal hernia repair with mesh has been standard practice since 1986.

Observation:

  • A 63-year-old male presented with weight loss, anorexia, fatigue, and a right lower quadrant mass.
  • Initial workup revealed a large inflammatory mass involving the cecum, unresponsive to biopsy, necessitating laparoscopy.
  • The patient had undergone right inguinal hernia repair with mesh 8 years prior.

Findings:

  • Diagnostic laparoscopy revealed an extensive mass involving the cecum, bladder, and transverse colon.
  • The mass required conversion to open laparotomy and right hemicolectomy.
  • A migrated mesh plug was found intimately involved with the resected specimen.

Implications:

  • Mesh plug migration is a rare complication of inguinal hernia repair.
  • This case represents the first report of mesh plug migration presenting as a suspected colonic malignancy.
  • Clinicians should consider mesh migration in the differential diagnosis of intra-abdominal masses in patients with prior hernia repair.

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