Narang K, Krishan A, Pisavadia B, Wadood A, Budhoo M, Zaman S
Sandwell General Hospital , Lyndon, West Bromwich , UK.
Ann R Coll Surg Engl. 2018 Aug 16;100(8):e1-e4. doi: 10.1308/rcsann.2018.0135.
Inguinal hernia repair can be performed via either an open or laparoscopic technique. Use of a mesh to repair the abdominal wall defect is now common practice, leading to a reduction in hernia recurrence but also associated with a number of complications. We report a rare case of a 49-year old man who presented 3 years after laparoscopic hernia repair with right-sided abdominal pain and loose stools. Colonoscopy and computed tomography revealed a mesh and fixation devices within the lumen of the caecum and ascending colon. The mesh was successfully excised with primary closure of the bowel defect. This case highlights the importance of recognising mesh migration as a complication of hernia repair, a phenomenon which can lead to serious morbidity. We suggest that patients should be informed of this risk during the consent process, while further research is needed to investigate how this occurrence can be prevented.
腹股沟疝修补术可通过开放或腹腔镜技术进行。使用补片修复腹壁缺损目前已成为常规做法,这导致疝复发率降低,但也伴有一些并发症。我们报告一例罕见病例,一名49岁男性在腹腔镜疝修补术后3年出现右侧腹痛和腹泻。结肠镜检查和计算机断层扫描显示盲肠和升结肠腔内有补片及固定装置。成功切除补片并对肠缺损进行一期缝合。该病例突出了认识到补片移位作为疝修补术并发症的重要性,这种现象可导致严重的发病情况。我们建议在知情同意过程中应告知患者这种风险,同时需要进一步研究以探讨如何预防这种情况的发生。