Lee Yujin, Bae Byung-Noe
Department of General Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2021 Jul;37(Suppl 1):S28-S33. doi: 10.3393/ac.2020.04.19. Epub 2020 May 15.
Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore, the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh (Ethicon) from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.
补片侵蚀或移位是疝修补术后一种罕见的晚期并发症。随着人工补片在腹壁疝修补术中的应用越来越广泛,其发生率也在上升。然而,补片移位极为罕见,其临床表现不典型且多样。因此,补片移位的处理应因人而异。本研究报告了一例94岁男性患者,在切口疝修补术后14年,普理灵补片(爱惜康公司)经腹壁全层移位至直肠。他仅表现为慢性腹痛和便秘。计算机断层扫描显示补片移位以及右腹壁与横结肠之间形成瘘管。通过手动从肛门取出补片,未出现任何后遗症。这些发现使该病例具有非典型性,因为补片经腔完全移位极为罕见,而且在许多情况下补片侵蚀或移位需要手术治疗。