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Intraperitoneal migration of a mesh plug with a small intestinal perforation: report of a case

Ming-Jenn Chen1, Yu-Feng Tian

  • 1Division of General Surgery, Department of Surgery, Yung Kung Campus, Chi Mei Medical Center, 901 Chung Hwa Road, Yung Kang, Tainan, 710, Taiwan.

Surgery Today
|May 25, 2010
PubMed

Insights

Mesh plugs for hernia repair can migrate, causing rare but serious bowel perforation. This case highlights the risk of mesh migration and suggests nonabsorbable sutures for fixation to prevent complications.

Area of Science:

  • Abdominal Surgery
  • Gastroenterology
  • Surgical Materials Science

Background:

  • Tension-free hernia repair using mesh plugs offers low recurrence rates.
  • However, rare complications such as mesh migration and peritoneal violation can occur.

Observation:

  • A 79-year-old male presented with acute abdomen 2 years after inguinal hernioplasty with a polypropylene mesh plug.
  • Previous laparotomy for bowel ischemia showed no plug migration or peritoneal protrusion.
  • Current laparotomy revealed mesh plug migration, peritoneal penetration, bowel perforation, and adhesions.

Findings:

  • This case represents the first documented instance of mesh plug migration demonstrated by serial tomography.
  • The migrated plug caused significant bowel perforation and adhesions, leading to acute abdominal symptoms.

Implications:

  • The findings underscore a rare but severe complication associated with mesh plug use in hernia repair.
  • Consideration of nonabsorbable sutures for mesh plug fixation may mitigate the risk of migration and subsequent bowel complications.

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