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Zhang Y, Lin H, Liu JM, Wang X, Cui YF, Lu ZY. Mesh erosion into the colon following repair of parastomal hernia: A case report. World J Gastrointest Surg 2023; 15:294-302. [PMID: 36896303 PMCID: PMC9988641 DOI: 10.4240/wjgs.v15.i2.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/25/2022] [Accepted: 02/09/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND In recent years, mesh has become a standard repair method for parastomal hernia surgery due to its low recurrence rate and low postoperative pain. However, using mesh to repair parastomal hernias also carries potential dangers. One of these dangers is mesh erosion, a rare but serious complication following hernia surgery, particularly parastomal hernia surgery, and has attracted the attention of surgeons in recent years.
CASE SUMMARY Herein, we report the case of a 67-year-old woman with mesh erosion after parastomal hernia surgery. The patient, who underwent parastomal hernia repair surgery 3 years prior, presented to the surgery clinic with a complaint of chronic abdominal pain upon resuming defecation through the anus. Three months later, a portion of the mesh was excreted from the patient’s anus and was removed by a doctor. Imaging revealed that the patient’s colon had formed a t-branch tube structure, which was formed by the mesh erosion. The surgery reconstructed the structure of the colon and eliminated potential bowel perforation.
CONCLUSION Surgeons should consider mesh erosion since it has an insidious development and is difficult to diagnose at the early stage.
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Affiliation(s)
- Yu Zhang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Han Lin
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Jia-Ming Liu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Xin Wang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yi-Feng Cui
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Zhao-Yang Lu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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Gavlin A, Kierans AS, Chen J, Song C, Guniganti P, Mazzariol FS. Imaging and Treatment of Complications of Abdominal and Pelvic Mesh Repair. Radiographics 2021; 40:432-453. [PMID: 32125951 DOI: 10.1148/rg.2020190106] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Surgical mesh is used most frequently for tension-free repair of abdominal wall hernias in adults, because the rate of hernia recurrence is lower with mesh than with primary soft-tissue repair. Since the introduction of polypropylene mesh in the middle of the 20th century, many mesh materials and configurations for specific surgical procedures have been developed. In addition to abdominal wall hernia repair, mesh may be used for repair of diaphragmatic hernias, urinary incontinence in women (female slings), genitourinary prolapse (vaginal mesh and sacrocolpopexy), rectal prolapse (rectopexy), and postprostatectomy male urinary incontinence (male slings). General mesh repair complications include chronic pain; fluid collections such as seromas, hematomas, and abscesses; adhesions that may lead to intestinal blockage; erosion into solid or hollow viscera including enterocutaneous fistulizing disease; and mesh failure characterized by mesh shrinkage, detachment, and migration with repair malfunction. Several mesh complications are often diagnosed with imaging, primarily with CT and less frequently with MRI and US, despite variable mesh visibility at imaging. This article reviews the common surgical mesh applications in the abdomen and pelvis, discusses imaging of mesh repair complications, and provides complication treatment highlights.©RSNA, 2020.
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Affiliation(s)
- Alexander Gavlin
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
| | - Andrea S Kierans
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
| | - Johnson Chen
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
| | - Christopher Song
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
| | - Preethi Guniganti
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
| | - Fernanda S Mazzariol
- From the Department of Radiology, Division of Abdominal Imaging, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, Box 141, New York, NY 10065
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Tonolini M. Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery. Diagn Interv Radiol 2016; 22:422-9. [PMID: 27460285 DOI: 10.5152/dir.2016.15578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Inguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since radiologists are increasingly requested to investigate suspected iatrogenic complications, this paper aims to provide an increased familiarity with early CT studies after IHR, including complications and normal postoperative appearances such as focal pseudolesions, in order to avoid misinterpretation and inappropriate management.
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Affiliation(s)
- Massimo Tonolini
- Department of Radiology, Luigi Sacco University Hospital, Milan, Italy.
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Gayer G, Petrovitch I, Jeffrey RB. Foreign objects encountered in the abdominal cavity at CT. Radiographics 2011; 31:409-28. [PMID: 21415187 DOI: 10.1148/rg.312105123] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Foreign objects are not infrequently seen at computed tomography (CT) of the abdomen and pelvis and may pose a diagnostic challenge to the radiologist, who must recognize the object, characterize its nature and location, and determine its clinical significance. Most foreign objects are incidentally detected at CT, but they may mimic a wide range of pathologic conditions. Some foreign objects (eg, an object that has been swallowed either intentionally or unintentionally) are the cause of the patient's signs and symptoms and require prompt medical attention. Other objects, such as a sponge or surgical instrument that has been retained postoperatively, may have medicolegal consequences. Furthermore, certain objects, such as intentionally concealed drug packets, may go undetected unless a high degree of suspicion exists and appropriate window settings are used to review the study. The radiologist should be familiar with the wide range of foreign objects that may be encountered at abdominopelvic CT, be able to recognize them promptly, and understand their implications for patient treatment.
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Affiliation(s)
- Gabriela Gayer
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
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Aganovic L, Ishioka KM, Hughes Cassidy F, Chu PK, Cosman BC. Plugoma: CT Findings after Prosthetic Plug Inguinal Hernia Repairs. J Am Coll Surg 2010; 211:481-4. [DOI: 10.1016/j.jamcollsurg.2010.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/05/2010] [Accepted: 06/01/2010] [Indexed: 11/16/2022]
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Inguinal hernia repair with the peduncled fascial flap: a new surgical technique. Hernia 2008; 13:161-6. [DOI: 10.1007/s10029-008-0454-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 10/24/2008] [Indexed: 10/21/2022]
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