A case of ventral hernia mesh migration with splenosis mimicking a gastric mass

Abstract

This case reports the presentation and investigation of a 64-year-old woman presenting with symptoms of bowel obstruction and found to have synchronous intraluminal migration of a polypropylene mesh from a ventral hernia repair and splenosis compressing the stomach wall. The use of synthetic mesh in any type of hernia repair has a number of risks, one of which is transmigration. This is a very rare complication but has been reported in a number of cases following both open and transabdominal pre-peritoneal repairs of inguinal hernias. Heterotopic splenic tissue or "splenosis" can be a cause of a soft tissue mass, which can mimic a neoplasm leading to misdiagnosis. These implants result from either splenic trauma or after splenic surgery.

The rare travellers

“…7 Depending on the different positional relationship of migrating mesh with visceral organs, clinical manifestations vary significantly and may present from 1 to 20 years after hernia repair. 8 Lower abdominal pain and mild tenderness were described in the majority of cases. 4,9 Incomplete peritoneal repair, inadequate fixation or inappropriate amount of implantation space are possible reasons accounting for mesh migrating into intraabdominal viscera, occasionally followed by fistulas formation or mechanical bowel obstruction.…”

Migration of Mesh through Trans-Rectal Route: An Unusual Complication of Laparoscopic Inguinal Hernia Repair

“…Mesh migration after laparoscopic inguinal hernia repair is just being encountered as an emerging complication. Only a hand full cases of mesh migration into urinary bladder, small bowel and large bowel after laparoscopic inguinal hernia repair have been reported so far [6][7][8][9][10][11][12][13][14]. In most of these reported cases, patients presented with abdominal complaints and underwent laparotomy with removal of mesh [7,8,[14][15][16].…”

Asymptomatic migration of ventral mesh for incisional hernia into the small intestine: A case report

“…Dieter reported in 1999 a case of mesh migration into the scrotum . In addition, a case of spontaneous evacuation per rectum has been reported, as well as ventral hernia mesh migration with splenosis mimicking a gastric mass …”