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开放性切口疝修补术后经壁e-PTFE抗粘连屏障网片迁移至小肠导致慢性贫血:一例报告

Chronic anemia due to transmural e-PTFE anti-adhesive barrier mesh migration in the small bowel after open incisional hernia repair: A case report.

作者信息

Ceci Francesca, D'Amore Linda, Annesi Elena, Bambi Lucia, Grimaldi Maria Romana, Gossetti Francesco, Negro Paolo

机构信息

Department of General Surgery "P. Stefanini", Sapienza, University of Rome, Italy.

Department of General Surgery "P. Stefanini", Sapienza, University of Rome, Italy.

出版信息

Int J Surg Case Rep. 2018;53:54-57. doi: 10.1016/j.ijscr.2018.10.012. Epub 2018 Oct 12.

Abstract

INTRODUCTION

Meshes are commonly employed in abdominal hernia repair to reduce recurrence rates. Prosthetic repair, however, increases the risk of mesh related complications, including migration into adjacent viscera and erosion which can occur as uncommon and can be difficult to be diagnose.

PRESENTATION OF CASE

This is a case of transmural migration of composite mesh into the bowel, presenting as chronic abdominal pain and anemia 14 years after incisional hernia repair.

DISCUSSION

Mesh implantation in hernia repair has increased the incidence of complications, such as seroma, hematoma and infection. Migration into adjacent viscera and erosion may present as complications related to the use of meshes. Their precise frequency after abdominal wall hernia repair is not well known and their late occurrence can make the diagnosis difficult.

CONCLUSION

Transmural migration of composite mesh is an uncommon complication of incisional hernia repair. Its pathogenesis is still not completely clear but it has been reported many years after implant surgery. It should be considered in a typical presentation of patients with history of previous prosthetic ventral hernia repair.

摘要

引言

在腹外疝修补术中通常使用补片以降低复发率。然而,人工材料修补会增加补片相关并发症的风险,包括补片移位至邻近脏器以及侵蚀,这些情况较为罕见且难以诊断。

病例报告

这是一例复合补片经肠壁移位至肠内的病例,表现为切口疝修补术后14年出现慢性腹痛和贫血。

讨论

疝修补术中植入补片增加了并发症的发生率,如血清肿、血肿和感染。补片移位至邻近脏器以及侵蚀可能是补片使用相关的并发症。腹壁疝修补术后这些并发症的确切发生率尚不清楚,且其迟发性表现会使诊断困难。

结论

复合补片经肠壁移位是切口疝修补术的一种罕见并发症。其发病机制仍不完全清楚,但在植入手术后多年已有报道。对于有既往人工材料修补腹疝病史的患者,若出现典型症状应考虑到这种情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa90/6214886/651557148f76/gr1.jpg

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