Colocutaneous Fistula after Open Inguinal Hernia Repair

Abstract

The plug-and-patch technique is frequently used for the open repair of inguinal hernias; however, serious complications may arise on rare occasions. We present the case of a 69-year-old patient who presented with a colocutaneous fistula with the sigmoid colon 9 years after the repair of a left sliding inguinal hernia with the plug-and-patch technique. The patient underwent sigmoidectomy and excision of the fistulous track. He was discharged on postoperative day 5 and had an uneventful recovery. Although such complications are reported rarely, the surgeon must be aware of them when deciding upon the method of hernia repair.

A Case of an Anomalous Tract Involving the Cecum After Open Right Inguinal Hernia Repair

“…Upon review of the literature, we have found seven cases of colocutaneous fistulas after open inguinal hernia repairs, presented below in Table 1. Six of these involved a left inguinal hernia and the sigmoid colon; five of the six utilized the plug and patch technique [1][2][3]6,11] and the remaining one employed the Lichtenstein technique [12]. Only one of the seven cases involved the cecum with plug and patch of a right inguinal hernia repair [5].…”

“…There are many plausible risk factors for mesh migration and/or fistula formation. These can be mechanical in nature, including inadequate initial anchoring, unsatisfactory placement of the mesh plug, direct contact between mesh and bowel, and type of hernia [1][2][3][4][5][6]8,11,12].…”

“…Inadequate initial anchoring could be due to poor fixation without sutures, with absorbable sutures, or suturing to low-quality tissue [1][2][3][4][5]. There is wide agreement throughout the reviewed studies that the mesh plug should be sutured either to the defect or the internal ring [1,4].…”

“…Inguinal hernia repair is one of the most commonly performed surgeries and is typically well tolerated and effective, with minimal serious complications [1][2][3]. They have a 10%-15% recurrence rate with primary tissue repair, with a higher rate of recurrence for each subsequent repair [1].…”

Intraperitoneal migrating mesh plug wrongfully taken for right colon cancer: A case report

“…Different types of synthetic mesh can be used. Nevertheless, complications have been reported, such as infection [ 3 ], bowel perforation [ 4 ],colo-cutaneous fistula [ 5 , 6 ] and migration [ 7 ]. In this paper, we report a case of a mesh migration into the abdominal cavity that has been taken for a right colonic malignancy.…”