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Migration of a mesh into the colon after inguinal hernia repair - a case report
Introduction:
Mesh migration is one of the least common complications that arise after inguinal hernia repair with a mesh. Only small case series have been reported, and an understanding of this issue is limited due to a lack of data. Most of the cases were treated surgically. In this paper, we wish to present the potential of treating this condition using endoscopic techniques.
Case Report:
A male patient underwent transabdominal preperitoneal repair of a primary inguinal hernia in 1999. In 2003, the patient required the same procedure for a recurrent inguinal hernia. Twenty years after the primary hernia repair, the patient had a positive faecal occult blood test but was completely asymptomatic. A colonoscopy revealed mesh migration into the sigmoid colon. Despite multiple attempts to remove the mesh endoscopically, endoscopic treatment was unsuccessful. The migrated mesh was surgically removed and obligatory resection of the sigmoid colon was carried out. Apart from wound infection (Clavien-Dindo IIIb), the postoperative course was uneventful.
Conclusion:
In our case, the mesh that had penetrated the colon could not be removed endoscopically. Despite our experience, it is advisable to attempt endoscopic removal of mesh that has migrated into a hollow intra-abdominal viscus.
Insights
Mesh migration after inguinal hernia repair is rare. Endoscopic removal attempts failed in a patient with mesh in the sigmoid colon, requiring surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Device Complications
Background:
- Mesh migration is a rare complication following inguinal hernia repair.
- Limited data exists on mesh migration, with most cases managed surgically.
- This case explores endoscopic treatment potential for mesh migration into the colon.
Observation:
- A patient with a history of inguinal hernia repair presented with asymptomatic mesh migration into the sigmoid colon.
- Colonoscopy confirmed mesh migration, and multiple endoscopic removal attempts were unsuccessful.
- Surgical removal of the mesh and sigmoid colon resection were ultimately required.
Findings:
- Endoscopic mesh removal was unsuccessful in this case of sigmoid colon migration.
- Surgical intervention was necessary for mesh removal and management of the complication.
- The patient experienced a wound infection (Clavien-Dindo IIIb) post-surgery.
Implications:
- While endoscopic removal is advisable for intra-abdominal mesh migration, success is not guaranteed.
- This case highlights the challenges and potential need for surgical intervention in complex mesh migration scenarios.
- Further research is needed to optimize management strategies for mesh migration complications.
