Mesh plug erosion into the small intestine after inguinal hernia repair: A case report

BACKGROUND Mesh plug(MP)erosion into the intra-abdominal organs is a rare but serious long-term complication after inguinal hernia repair(IHR),and may lead to aggravation of symptoms if not treated promptly.It is difficult to diagnose MP erosion as there are no obvious specific clinical manifestations,and surgery is often needed for confirmation.In recent years,with the increased understanding of postoperative complications,MP eroding into the intra-abdominal organs has been a cause for concern among surgeons.CASE SUMMARY A 50-year-old man was referred to the Department of General Surgery with the complaint of abdominal pain in the right lower quadrant for 2 d.He had a surgical history of right open IHR and partial thyroidectomy performed 20 years and 15 years ago,respectively.Computed tomography revealed a circinate highdensity image with short segmental thickening of the ileum stuck to the abdominal wall,and no evidence of recurrent inguinal hernia.Laparoscopic abdominal exploration confirmed adhesion of the middle segmental portion of the ileal loop to the right inguinal abdominal wall;the rest of the small intestine was normal.Further exploration revealed migration of the polypropylene MP into the intraperitoneal cavity and formation of granulation tissue around the plug,which eroded the ileum.Partial resection of the ileum,including the MP and end-to-side anastomosis with an anastomat,was performed.CONCLUSION Surgeons should aim to improve their ability to predict patients at high risk for MP erosion after IHR.

Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography:A case report

BACKGROUND Primary retroperitoneal liposarcoma(PRPLS)is a rare soft tissue tumor with nonspecific clinical symptoms;it has different computed tomography(CT)image features according to pathological types.Some patients with a single tumor have been previously reported in the literature.We present an exceptional case of a PRPLS patient with multiple large tumors exhibiting different patterns of appearance on CT and confirmed as atypical lipomatous tumor/welldifferentiated liposarcoma by postoperative pathology.CASE SUMMARY A 64-year-old man presented with abdominal distension for 1 year.The patient was diagnosed with PRPLS based on physical examination,laparotomy,ultrasonography,CT scan,and surgery.Both of the tumors were completely resected through surgery and confirmed as atypical lipomatous tumor/welldifferentiated liposarcoma by postoperative pathology.The postoperative course was uneventful without recurrence or metastasis,as demonstrated by abdominalpelvic CT during an 18 mo follow-up.CONCLUSION Multiple large Well-differentiated liposarcomas with different patterns of appearance on CT image can occur simultaneously in the same patient,to which more attention should be paid to make an effective differential diagnosis.

Combination of Chinese and Western medicine in the treatment of aggressive angiomyxoma:a case report

Aggressive angiomyxoma(AAM)is a rare soft tissue tumor.Invasiveness and recurrence are important clinical features of AAM.A patient with recurrent AAM was admitted to the hospital.At present,the treatment for AAM is still based on surgery because it does not have lymph nodes and distant metastasis.Moreover,chemotherapy is of little significance.Traditional Chinese medicine believes the formation of tumor is related to blood stasis,so after surgery,a Chinese medicine called Xue-Shuan-Tong was used to improve blood circulation and disperses stasis.The drainage tube was removed on the 5th day after the operation and achieved a good wound healing.This article analyzes and demonstrates the pathogenesis of female vulvar invasive angiomyxoma from the perspective of modern medicine and traditional medicine,in order to provide a better understanding of the disease.