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 diff...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.展开更多
The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a "rolled plug" fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in...The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a "rolled plug" fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in 1993. In the following years, this technique and the type and size of plug have been modified deliberately by others. The technique now is commonly used to repair inguinal hernia but complications occur because of migration of mesh plug after open inguinal hernioplasty. We present a case of strangulated bowel obstruction-resulting from migration of mesh plug after open inguinal hernioplasty.展开更多
基金Supported by the Medical Science Research Project of Hebei Provincial Health Commission,No. 20211642Key Research and Development Project of Hebei Province,No.21377773D
文摘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.
文摘The use of mesh plug in hernioplasty was introduced by Shulman et al in 1990 as a "rolled plug" fixed with two stitches to close the internal inguinal ring. Robbins and Rutkow described their mesh plug technique in 1993. In the following years, this technique and the type and size of plug have been modified deliberately by others. The technique now is commonly used to repair inguinal hernia but complications occur because of migration of mesh plug after open inguinal hernioplasty. We present a case of strangulated bowel obstruction-resulting from migration of mesh plug after open inguinal hernioplasty.