Klein Fritz, Ospina Carlos, Rudolph Birgit, Wüstefeld Joost, Denecke Timm, Neuhaus Peter, Schmidt Sven-Christian
Department of General, Visceral, and Transplantation Surgery, Charité Campus Virchow, Universitätsmedizin Berlin, Berlin, Germany.
Surg Laparosc Endosc Percutan Tech. 2012 Oct;22(5):e288-90. doi: 10.1097/SLE.0b013e31825efc3c.
The case of a 58-year-old male patient who developed a chronic pain syndrome after laparoscopic intraperitoneal onlay mesh for treatment of a large symptomatic umbilical hernia combined with rectus diastasis is reported. Twelve months after an uncomplicated initial surgery, the patient presented with progressive signs of a foreign body sensation and pain in the anterior abdominal wall. Computed tomography examination revealed no pathologic findings but a marked shrinkage of the mesh implant. Because of further progressive symptoms, explorative laparotomy was performed. Mesh shrinkage and adhesions with a surrounding chronic tissue reaction were found as the cause of the pain syndrome. This case demonstrates a case of a chronic pain syndrome due to mesh shrinkage 12 months after initial ventral hernia repair. Mesh shrinkage should therefore be taken into consideration in patients with progressive pain chronic syndromes after laparoscopic ventral hernia repair.
报告了一例58岁男性患者，其在接受腹腔镜腹腔内置补片治疗大型有症状脐疝合并腹直肌分离后出现慢性疼痛综合征。初次手术顺利完成12个月后，患者出现前腹壁异物感和疼痛的进行性症状。计算机断层扫描检查未发现病理结果，但补片植入物明显收缩。由于症状进一步进展，遂进行了剖腹探查术。发现补片收缩以及与周围慢性组织反应的粘连是疼痛综合征的原因。该病例表明，初次腹疝修补术后12个月因补片收缩导致慢性疼痛综合征。因此，对于腹腔镜腹疝修补术后出现进行性疼痛慢性综合征的患者，应考虑补片收缩的情况。
