Mesh Migration Into the Sigmoid Colon Identified After Positive Fecal Occult Blood Test: A Case Report

Inguinal hernia repair with mesh reconstruction is amongst the most frequently performed elective general surgical procedures and is associated with well-recognized complications such as recurrence, infection, and chronic pain. Rarer complications of mesh repair have also been reported, particularly since the advent of laparoscopic inguinal hernia repair. This report highlights an important, rare complication of left-sided hernia repair, which should be considered by surgeons, particularly in the presence of certain associated risk factors.  A 72-year-old man underwent colonoscopy following a positive fecal occult blood test (FOBT). The patient had a history of open left inguinal hernia repair 19 years previously, complicated by chronic wound infection. Computed tomography (CT) showed three nonspecific calcified fragments in the proximal sigmoid colon with associated diverticulosis. Flexible sigmoidoscopy confirmed erosion of the surgical mesh through the colonic mucosa. The patient underwent a laparoscopic high anterior resection with primary anastomosis and made an unremarkable recovery.  This case highlights a rare but important late complication of a common elective general surgical procedure and adds to the body of evidence in this area. Sigmoid diverticulosis may represent a rare complicating factor in elective left-sided hernia repair.