Kuroiwa Masatsugu, Kitazawa Masato, Miyagawa Yusuke, Muranaka Futoshi, Tokumaru Shigeo, Nakamura Satoshi, Koyama Makoto, Yamamoto Yuta, Hondo Nao, Ehara Takehito, Miyazaki Satoru, Tanaka Hirokazu, Soejima Yuji
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Case Rep Surg. 2021 Oct 25;2021:5683621. doi: 10.1155/2021/5683621. eCollection 2021.
Tension-free repair using mesh has become the standard treatment for abdominal wall incisional hernias. However, its postoperative complications reportedly include mesh infection, adhesions, and fistula formation in other organs. Here, we report an extremely rare case of mesh migration into the neobladder and ileum with entero-neobladder and neobladder-cutaneous fistulas. . An 80-year-old male who had undergone radical cystectomy 5 years ago and abdominal wall incisional hernia repair 3 years ago presented with fever and abdominal pain. Computed tomography (CT) scan revealed mesh migration into the neobladder and ileum. He was treated conservatively with antibiotics for a month but did not show improvement; hence, he was transferred to our hospital. He was diagnosed with mesh migration into the neobladder and ileum with complicated fistula formation. He underwent mesh removal, partial neobladder resection, and partial small bowel resection. He developed superficial incisional surgical site infection, which improved with drainage and antibiotics, and he was discharged 40 days after the surgery.
We reported a rare case of mesh migration into the neobladder and ileum with fistula formation. Successful conservative treatment cannot be expected for this condition because mesh migration into the intestinal tract causes infection and fistula formation. Hernia repair requires careful placement of the mesh such that it does not come into contact with the intestinal tract. Early surgical intervention is important if migration into the intestinal tract is observed.
使用补片的无张力修补术已成为腹壁切口疝的标准治疗方法。然而，据报道其术后并发症包括补片感染、粘连以及其他器官形成瘘管。在此，我们报告一例极为罕见的补片移位至新膀胱和回肠，并伴有肠新膀胱瘘和新膀胱皮肤瘘的病例。一名80岁男性，5年前接受了根治性膀胱切除术，3年前接受了腹壁切口疝修补术，现出现发热和腹痛。计算机断层扫描（CT）显示补片移位至新膀胱和回肠。他接受了为期一个月的抗生素保守治疗，但未见改善；因此，他被转至我院。他被诊断为补片移位至新膀胱和回肠并伴有复杂的瘘管形成。他接受了补片取出、部分新膀胱切除术和部分小肠切除术。他出现了手术切口浅表部位感染，经引流和抗生素治疗后好转，术后40天出院。
我们报告了一例罕见的补片移位至新膀胱和回肠并伴有瘘管形成的病例。对于这种情况，不能期望成功的保守治疗，因为补片移位至肠道会导致感染和瘘管形成。疝修补术需要谨慎放置补片，使其不与肠道接触。如果观察到补片移位至肠道，早期手术干预很重要。
