Tomioka Kodai, Fujioka Toshihiro, Satoh Tohru, Makita Hidetoshi, Tsukui Rika, Aoki Takeshi, Murakami Masahiko
Department of Surgery, Makita General Hospital, Tokyo, Japan.
Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan.
J Surg Case Rep. 2020 Oct 20;2020(10):rjaa409. doi: 10.1093/jscr/rjaa409. eCollection 2020 Oct.
The occurrence of late-onset mesh infection and mesh invasion into the intestine after abdominal incisional hernia repair is extremely rare. Herein, we describe the first case of late-onset mesh infection and mesh penetrating the transverse colon and small intestine 5 years after incisional hernia repair using an expanded polytetrafluoroethylene mesh. The symptom was drainage from the reddish wound, and computed tomography scan revealed intestinal prolapse with local wall thickening. The mesh removal and small intestine and colon resection were conducted because the small intestine and transverse colon formed a mass containing the mesh inside. The events were caused by the lack of mesh fixation, and the dislodged mesh penetrating the intestinal tract caused the infection. For mesh infections in which conservative treatment is not effective, mesh removal and organ excision should not be delayed regardless whether there is a strong adhesion of the abdominal cavity.
腹部切口疝修补术后迟发性补片感染及补片侵入肠道的情况极为罕见。在此，我们报告首例使用膨体聚四氟乙烯补片进行切口疝修补术后5年发生迟发性补片感染且补片穿透横结肠和小肠的病例。症状为伤口发红并有渗液，计算机断层扫描显示肠脱垂伴局部肠壁增厚。由于小肠和横结肠形成了一个包含补片的肿块，因此进行了补片移除以及小肠和结肠切除术。这些情况是由于补片固定不足导致的，移位的补片穿透肠道引起了感染。对于保守治疗无效的补片感染，无论腹腔是否存在严重粘连，都不应延迟补片移除和器官切除。
