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Small-bowel obstruction and bladder injury due to retropubic sling malposition in the peritoneal cavity
Sílvio Henrique Maia de Almeida1, Ricardo Brandina, Vinicius Dall'Aqua
1Department of Surgery, Discipline of Urology, Universidade Estadual de Londrina, Rua Francisco Marcelino da Silva, 270, Londrina, Paraná, Brazil. salmeida@sercomtel.com.br
We report a case of small-bowel obstruction caused by an internal hernia produced by the presence of an intraperitoneal sling mesh. A woman with a history of multiple abdominal surgeries was referred from another center after a sling procedure. On the fifth day after surgery, she developed small-bowel obstruction. Exploratory laparotomy showed the distal ileum compressed between the visceral peritoneum of the bladder and a loop mesh sling. The segment of ileum was repositioned into the peritoneal cavity and the sling segment was resected. In cases of small-bowel obstructions after a mesh surgery, one must be aware of the possibility of bowel entrapment and that the mere presence of intraperitoneal tape can trigger the obstruction.
We report a case of small-bowel obstruction caused by an internal hernia produced by the presence of an intraperitoneal sling mesh. A woman with a history of multiple abdominal surgeries was referred from another center after a sling procedure. On the fifth day after surgery, she developed small-bowel obstruction. Exploratory laparotomy showed the distal ileum compressed between the visceral peritoneum of the bladder and a loop mesh sling. The segment of ileum was repositioned into the peritoneal cavity and the sling segment was resected. In cases of small-bowel obstructions after a mesh surgery, one must be aware of the possibility of bowel entrapment and that the mere presence of intraperitoneal tape can trigger the obstruction.
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