Unusual complication of seroma after ventral hernia mesh repair: Digestive perforation by tacks. A case report

Area of Science:

• Abdominal Surgery
• Surgical Materials

Background:

• Intraperitoneal meshes are standard for ventral hernia repair, offering benefits like reduced operative time and pain.
• Seroma formation is a common complication, typically resolving without intervention.
• Mesh fixation methods include tackers, sutures, and glue, with limited data on associated complications.

Purpose of the Study:

• To report an unusual complication of intraperitoneal mesh repair: a digestive fistula.
• To discuss the potential link between infected seroma and tack migration/adhesion.
• To emphasize the importance of timely intervention in complicated mesh repairs.

Main Methods:

• Case report of a patient undergoing laparoscopic incisional hernia repair with mesh.
• Management of an infected bulky seroma with medical treatment and percutaneous drainage.
• Investigation of an unexpected complication involving a small bowel fistula.

Main Results:

• The patient developed an infected seroma post-repair.
• An unusual complication of a small bowel fistula occurred within the seroma cavity, attributed to a tack.
• Conservative management of the seroma preceded the identification of the fistula.

Conclusions:

• While conservative seroma treatment can preserve mesh, this case underscores the risk of tack-related complications, including digestive fistulas.
• The pressure from a complicated seroma may contribute to tack adherence and subsequent bowel injury.
• Prompt mesh removal should be considered in cases of complicated seroma with tack fixation to prevent severe outcomes.