HighlightsIncisional hernia is not an uncommon complication after abdominal operation.Mesh migration and erosion causing vesico-cutaneous fistula and subsequent necrotizing fasciitis is uncommon.We hereby report a case of abdominal wall necrotizing fasciitis 21 months after laparoscopic incisional hernia repair in lower midline with dual mesh, due to mesh migration and erosion into urinary bladder, resulting in fistulation between bladder and abdominal wall.Mesh erosion to viscera can cause severe complication. Its risk should be balanced and discussed with patient with full consent.

Bouveret's Syndrome is a rare cause of gastric outlet obstruction secondary to the impaction of a gallstone within a cholecystogastric or cholecystoduodenal fistula. It is a rare variant of gallstone ileus. Prompt diagnosis, appropriate investigations and proper treatment are essential. The aim of the present case report was to review the currently-available literature regarding Bouveret's syndrome management approach and to share our experience. A 69-year-old man presented to our surgical unit with a 1-week history of upper gastrointestinal bleeding and gastric outlet obstruction symptoms. The diagnosis of Bouveret's Syndrome was confirmed with computed tomography. He subsequently underwent a one-stage open partial gastrectomy and cholecystectomy with Roux-en-Y anastomosis and controlled duodenostomy. Postoperative recovery was uneventful and the patient was discharged on postoperative day 11. With the current paucity of high-level evidence regarding the management approach for Bouveret's syndrome, the gold standard management algorithm is yet to be developed. The management approach should be tailored, with an appropriate choice of treatment based on the patient's clinical presentation and comorbidities and the expertise available. Surgical approach should be considered if endoscopic treatment is not feasible or has failed.