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Cecum perforation by plug migration: an unexpected late complication of inguinal hernia mesh repair

Filipa Policarpo1, Ana Alves Rafael1, Miguel Fróis Borges1

  • 1Department of General Surgery, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.

Journal of Surgical Case Reports
|March 17, 2023
PubMed

Insights

A rare case of polypropylene mesh migration after inguinal hernia repair led to a cecal fistula and perforation. Prompt surgical intervention successfully treated this serious complication.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Medical Device Complications

Background:

  • Inguinal hernia repair often involves synthetic mesh prostheses.
  • While generally safe, mesh migration is a rare but serious complication.
  • Previous Rutkow-Robbins repair in a 79-year-old male patient.

Observation:

  • Patient presented with an inguinal inflammatory mass and bowel obstruction.
  • Emergency surgery revealed an intraperitoneal polypropylene plug causing a cecal fistula and perforation.
  • An abscess was present in the abdominal wall.

Findings:

  • Successful en bloc resection of the cecum with the migrated mesh plug.
  • Abdominal wall abscess drainage was performed.
  • The patient experienced an uneventful postoperative recovery.

Implications:

  • Highlights the potential for severe complications from mesh migration.
  • Emphasizes the need for vigilance in diagnosing and managing such rare events.
  • Suggests a review of mesh-related complications in hernia surgery.

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