Intraperitoneal Migration of a Mesh Plug from a Hernioplasty Forming a Colocutaneous Fistula with the Cecum: Report of a Case

Abstract

Tension-free hernia repair with a mesh plug causes relatively low postoperative pain and allows an earlier return to work, as well as a low recurrence rate. Occasionally, however, hernioplasty can result in complications including mesh migration and invasion of intra-abdominal organs. This report describes the case of a 57-year-old man who had undergone a right inguinal hernioplasty 13 years previously. Recovery was uneventful until he experienced inflammation of the groin, and required open drainage three times for a refractory abscess in his right groin. Additional colonoscopy and x-ray examinations with contrast medium clearly demonstrated a mesh plug that had migrated and penetrated the cecum, forming a colocutaneous fistula. The mesh was successfully removed under general anesthesia, and the inflammation in the groin resolved. (J Nippon Med Sch 2015; 82: 246 249)

Mesh Plug Migration Into the Ileum 11 Years After Open Inguinal Hernia Repair: A Rare Case Report and Literature Review

“…The surgeons who perform mesh-plug hernia repair should be careful to peel off the preperitoneal layer enough, remove the peritoneal tension, avoid placing the mesh plug too deep, and avoid damaging the peritoneal sac, because the organ penetration of mesh plug is caused by (a) intraperitoneal exposure of the prosthesis, (b) long-term compression of the peritoneum, (c) deviation from the fixed position due to fixation failure, and (d) intra-abdominal migration. 5,6,9 In conclusion, although migration of the mesh plug into the intestinal lumen is quite rare, it is important for surgeons to recognize this late-onset complication.…”

“…From 2000 to 2016, complications after mesh plug hernia repair related to organ penetration were reported in 13 cases, including ours (Table 1). [4][5][6][7][8][9][10][11][12][13][14][15] The average patient age was 66.8 years (range: 30-85 years old), and there were 12 males. The average duration from hernia repair was 6.5 years (range: 2-20 years).…”

Surgical mesh migration with Rutkow-Robbins technique causing appendicitis: A case report

“…However, relevant complications associated with mesh migration regarding the Rutkow and Robbins technique have been reported, such as chronic pain, bowel occlusion, intraperitoneal meshes, and adhesion to intraperitoneal structures such as the iliac vein, deep vein thrombosis due to fibrosis around the vessel, recurrence with migration to the scrotum, and small bowel fistula. 4,5,[8][9][10][11] .…”

Colocutaneous Fistula after Open Inguinal Hernia Repair

“…In the two cases a mesh plug was used for the repair [ 1 , 2 ] and the third case was after a Lichtenstein repair [ 3 ]. Colocutaneous fistula with the cecum has been reported more rarely [ 4 ]. Other cases with plug complications involving the sigmoid colon have been described and presented clinically as intra-abdominal abscesses [ 5 , 6 ] or sigmoid obstruction [ 7 ].…”