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补片移位导致盲肠穿孔:腹股沟疝补片修补术意外的晚期并发症

Cecum perforation by plug migration: an unexpected late complication of inguinal hernia mesh repair.

作者信息

Policarpo Filipa, Rafael Ana Alves, Borges Miguel Fróis, Azevedo Fernando

机构信息

Department of General Surgery, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.

出版信息

J Surg Case Rep. 2023 Mar 14;2023(3):rjad137. doi: 10.1093/jscr/rjad137. eCollection 2023 Mar.

Abstract

Case of a 79-year-old male previously submitted to Rutkow-Robbins inguinal hernia repair. He presented himself at the Emergency Room with an inguinal inflammatory mass and bowel obstruction for 5 days. A strangulated recurrent inguinal hernia was assumed and emergency surgery was performed. Since an inguinal abscess was present, a midline laparotomy was performed. The previous polypropylene plug was found in an intraperitoneal position, fistulizing to the cecum and creating a 2 cm wide perforation, without intraperitoneal collections or bowel compromise. An atypical resection of the cecum with the plug was performed and the abdominal wall abscess was drained. The patient had a slow, but uneventful postoperative course. Given the rarity of cases, the high variability of clinical presentation and the potential seriousness of mesh migration complications, the authors review the topic of mesh migration.

摘要

一名79岁男性患者,此前接受过鲁特科夫 - 罗宾斯腹股沟疝修补术。他因腹股沟炎性肿块和肠梗阻5天前来急诊室就诊。考虑为绞窄性复发性腹股沟疝,遂进行急诊手术。由于存在腹股沟脓肿,故行正中剖腹术。发现先前的聚丙烯补片位于腹腔内,与盲肠形成瘘管并造成2厘米宽的穿孔,无腹腔内积液或肠管受损。对盲肠和补片进行了非典型切除,并引流了腹壁脓肿。患者术后恢复缓慢,但过程平稳。鉴于此类病例罕见、临床表现高度可变以及补片移位并发症的潜在严重性,作者对补片移位这一主题进行了综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9566/10014169/b879fb6d40f3/rjad137f1.jpg

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