Transmural Mesh Migration From the Abdominal Wall to the Rectum After Hernia Repair Using a Prolene Mesh: A Case Report

Abstract

Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.

Gastrocutaneous fistula caused by mesh migration following diaphragmatic rupture repair

“…Besides, several mesh‐related adverse effects such as adhesion, migration, infection, viscera erosion and fistula formation have been documented 3 . In addition, insufficient fixation may cause the mesh to move along adjacent anatomical planes 4 . In our case, possible contributing factors for gastrocutaneous fistula include physical contact and adhesion, inflammatory response caused by the previous operation and inadequate fixation, although this final possibility is less likely.…”

Spontaneous Migration of Intraperitoneal Mesh into Rectum following Ventral Hernia Repair

“…One of them was the preperitoneal placement of polypropylene mesh evacuated manually from the rectum after 14 years. 8 Another case was polypropylene and expanded polytetrafluoroethylene mesh placed intraperitoneally evacuated from the rectum after 2 years. 9 In both the above cases primary surgery was open repair and not laparoscopic.…”