Nogueiro Jorge, Santos-Sousa Hugo, de Almeida Marinho, Malheiro Luis, Barbosa Elisabete
Department of General Surgery, São João University Hospital Center, Porto, Portugal.
Case Rep Surg. 2021 Sep 14;2021:2007935. doi: 10.1155/2021/2007935. eCollection 2021.
Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the "recoil ring" from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis.
急性阑尾炎是一种非常常见的病症。疝修补网片移位很少见，尤其是腔内移位。我们旨在报告一例腹股沟疝修补网片移位表现为急性阑尾炎的病例。一名58岁男性八年前曾接受过使用PolySoft™疝修补补片的ONSTEP右侧腹股沟疝修补术，因急性阑尾炎入住急诊科，并接受了腹腔镜阑尾切除术。术中，腹股沟疝修补补片的“回缩环”从腹壁前部延伸至阑尾，穿透阑尾并在腔内延伸。进行了阑尾切除术，并通过前路取出了补片。疝修补网片移位至腔内位置极为罕见，文献中仅描述了少数病例。移位的发病机制仍知之甚少。在先前存在疝缺损矫正且处于正确临床背景下时，临床医生在急性阑尾炎病因的鉴别诊断中应考虑疝修补网片移位。据我们所知，这是首例报道的腹股沟疝修补网片移位至阑尾并表现为急性阑尾炎的病例。
