Appendico-cutaneous fistula 20 years after groin hernia repair with a polypropylene plug

Wijers, Olivier; Conijn, A.P.; Wiese, H.; Sjer, Mike

doi:10.1136/bcr-2013-009801

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Of the patients with fistulae to the skin, three of these were within Amyand (inguinal) hernias, of which one patient also had a history of Hirschsprung's disease, and another case projected from a De Gangerot (femoral) hernia…”

Section: Resultsmentioning

confidence: 99%

Fistulae involving the appendix: a systematic review of the literature

McDonald

Lee

Dean

et al. 2020

ANZ Journal of Surgery

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Background The appendix has a unique place in surgical history. Although the first ever appendicectomy involved a fistula to the skin, fistulae involving the appendix remain uncommon and can lead to unique surgical considerations. Methods A systematic review of the literature was performed for case reports of appendiceal fistulae. We excluded cases in which the patient had a history of appendicectomy. Cases were categorized by site and aetiology, with information regarding relative frequency and demographics obtained. Results A total of 301 case reports of fistula involving the appendix were found. The most common sites of these fistulae were to the bladder (148 cases), skin (40 cases), vasculature (19 cases), umbilicus (16 cases) and to the gastrointestinal tract. The most common aetiology in sub‐analysis was appendicitis alone (150 cases), with less common causes including appendiceal adenocarcinoma (32 cases) and congenital abnormalities (18 cases). There were significantly more appendiceal fistulae in males than in females, with a ratio of 1.7:1. In patients with appendiceal adenocarcinoma as a cause for fistula, there were significantly more females than males with a ratio of 2.3:1. Conclusion In conducting a systematic review of case reports of fistulae involving the appendix, we identified 301 unique case reports, with a range of different sites and aetiologies.

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Section: Resultsmentioning

confidence: 99%

Fistulae involving the appendix: a systematic review of the literature

McDonald

Lee

Dean

et al. 2020

ANZ Journal of Surgery

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“…Th e position of the PHS connector in internal hernia ring and lateral position of spermatic cord through onlay patch after placement of underlay patch could be an important factor in 'squeezing' the nerves in the original technique 14,15 . Another problem with putting the PHS connector and underlay patch through internal hernia ring is damage to parietal peritoneum and the possibility of direct contact with small or large intestine, which could lead to damage to the intestinal wall and septic complication 16,17 . In our placement modifi cation, by moving the PHS connector 'lower' or medially in Hesselbach triangle through separate opening of transverse fascia we eliminate the possibility of 'squeezing' the nerves and spermatic cord in internal ring, and avoid direct contact with peritoneal contents of underlay patch alone or together with the connector.…”

Section: Discussionmentioning

confidence: 99%

‘Plug Free’ Connector Placement Modification of a Bilayer Patch Device in Male Indirect Inguinal Hernioplasty

Ilić

Putnik

2016

acc

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SUMMARY -Th e bilayer patch device (Ethicon, Prolen Hernia System®) for inguinal hernia repair has a connector that acts as a ‚plug' in the internal inguinal ring. Th e position of this ‚plug' component may be responsible for higher incidence of chronic pain and intestinal damage. We assumed that changing the position of the connector of a bilayer patch device (PHS ® ) and placing it medially in Hesselbach triangle would contribute to lower incidence of chronic pain and would not result in intestinal damage, with good clinical outcome following indirect inguinal hernioplasty. Th is retrospective study included 73 patients with 76 indirect inguinal hernias, who underwent the procedure of modifying the position of the bilayer patch device in the 2005-2015 period. Th e mean age of the patients was 57 years. Th ree patients had early postoperative complications (3.95%), two of which had postoperative seroma and one had postoperative pain. Th ree patients (3.95%) had late postoperative complications. One patient (1.32%) had chronic pain. Th ere was one recurrence (1.32%) and one patient (1.32%) needed the mesh removed due to discomfort. Th e 'plug free' position of the connector of a bilayer patch device in patients with indirect inguinal hernioplasty is a safe procedure with low rate of chronic pain, no intestinal damage, and standard low recurrence.

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“…Reported appendiceal pathologies leading to appendiceal fistula include acute appendicitis, periappendiceal abscess, incomplete appendicectomy, malignancy (mucinous adenocarcinoma), goblet cell carcinoid, isolated Crohn's disease, appendiceal diverticulitis, papillovillous adenoma, and neuroma . Reports of adjacent pathologies leading to appendiceal fistula include malignancy (cervical squamous cell carcinoma); sigmoid diverticulitis; Hirschsprung's disease; cystic fibrosis; abdominal aortic aneurysm (primary and secondary to repair); arterial reconstruction; and recent or previous surgery (trauma laparotomy, hysterectomy, transurethral resection of prostate, transurethral resection of bladder tumor with Mitomycin C, right inguinal hernia repair, and right groin hernia repair with propylene plug).…”

Section: Introductionmentioning

confidence: 99%