Intraperitoneal coated polypropylene hernia meshes: the dark side of the moon

To date, the use of meshes in repairing abdominal wall defects has brought many advantages, especially in terms of recurrence prevention, but it is not exempt from complications, such as chronic pain, entero-cutaneous fistulas and intestinal obstruction. Here we report a case of intestinal obstruction in a patient with a large umbilical hernia treated laparoscopically by means of a composite polypropylene mesh, six year before.

A 49-year-old man came to our care with a 3-day history of central and right lower abdominal quadrant pain and a clinical picture of intestinal obstruction. Six years before the patient underwent a laparoscopic intervention to repair his umbilical hernia, with the positioning of a polypropylene coated mesh. Abdominal ultrasonography (US) confirmed the obstruction and demonstrated adhesions between an intestinal loop and the mesh. Intraoperatively, obstruction was confirmed and an intestinal segment had to be resected.

Small bowel obstruction is an uncommon but possible late complication after laparoscopic hernia repair with coated polypropylene mesh.