Intraluminal mesh migration causing enteroenteric and enterocutaneous fistula: a case and discussion of the ‘mesh problem’

Abstract

The use of synthetic mesh in the abdominal compartment has recently become a topic of debate as high profile public cases have called into question their safety. Several case reports have demonstrated significant complications due to intra-abdominal mesh. Furthermore, some studies have suggested that the rates of these severe complications are underestimated. We present the case of a patient who developed an enteroenteric and enterocutaenous fistulae, an abdominal wall collection and an intraperitoneal inflammatory mass from intraluminal migration of a synthetic mesh inserted during laparoscopic incisional hernia repair. We discuss the considerations and complications of using synthetic mesh for ventral hernia repair and discuss the scientific evidence behind the increasingly apparent 'mesh problem'.

Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

“…Hypothetically, resorbable materials seem preferential over permanent meshes that remain in the body, as they might reduce fear and anxiety, and possibly reduce chronic pain development and sinus formation due to the occasionally described shrinkage of permanent synthetic mesh products [31]. Resorbable meshes might additionally prevent the risk of developing the (rare) complication of enterocutaneous fistula [32][33][34]. Additionally, due to being resorbed, biosynthetic meshes might possibly be more suitable in contaminated wound sites or high-risk patients.…”

Axioms and theorems in the treatment of large and giant postoperative hernias

“…But the relevance of choosing a hernioplasty method for hernia defects W3-W4 does not decrease. The search for effective tactics in POVH goes in two directions: on the one hand, minimally invasive approaches with laparoscopic access and the use of robotics are being introduced [28,[44][45][46][47]; on the other hand, surgical algorithms for strengthening AAW using the tension-free method are being improved [47]. Despite all the advantages, endoscopic approaches are not popular in actual practice in the plastic surgery of large and giant POVH with domain loss [28,47,48].…”

Unusual case of post‐operative small bowel obstruction

“…Additional cases of migrated mesh repairs have been rarely reported . In addition to bowel obstruction, complications include enteroenteric, enterocutaneous and bladder fistula …”