Acute Appendicitis Caused by the Migration of the Prosthetic Mesh Used for Open Indirect Inguinal Hernia Repair into the Peritoneal Cavity

Abstract

This is an unusual case of a 55-year-old male with appendicitis caused by the incarceration of the appendix in an area of tissue reaction from a prosthetic mesh used for open inguinal hernia repair which migrated trans anatomically from the right inguinal area into the right lower peritoneal cavity. Isolated appendicitis caused by such phenomenon has never been reported in current literature. Introduction: Appendectomy is the most common emergency procedure worldwide. Approximately seven percent of the total population worldwide will undergo appendectomy during their lifetime. The rate of appendectomy for appendicitis is estimated at 10 per 10,000 patients per year.1-3 Appendicitis is commonly caused by luminal obstruction. The most common etiology of obstruction is fecalith. Other causes include lymphoid hypertrophy, inspissated barium, parasites, small vegetable seeds and tumors. Rarely, appendicitis could be secondary to ingested nondietary foreign bodies4-10, procedures11 and trauma.12-15 There has been no reported case of appendicitis caused by prosthetic mesh migration from the inguinal area into the peritoneal cavity. The authors searched MEDLINE using the following MeSH terms: appendicitis, inguinal hernia, mesh herniorraphy and mesh migration. Key words: Appendicitis, inguinal hernia, mesh herniorraphy, mesh migration, polypropylene mesh, prosthetic mesh