Abstract
Tension-free hernia repair with a mesh plug shows a low recurrence rate, but in a very few cases it can result in new complications including mesh migration and violation of the peritoneum. This report describes the case of a 79-year-old man who had undergone an inguinal hernioplasty using a polypropylene mesh plug 2 years earlier. He had a laparotomy for bowel ischemia 18 months later, and no evidence of bowel adhesion or a plug protruding through the peritoneum at that time. The patient remained asymptomatic until this admission. He presented with acute abdomen, and an emergency laparotomy revealed a plug-related bowel perforation. The plug had migrated and penetrated the peritoneum, presenting with bowel perforation and adhesions. Although the etiology was not clear, the use of nonabsorbable sutures for plug fixation may be recommended to avoid this complication. Less than 10 cases of mesh migration with bowel complications have been reported, and this is the first case study to demonstrate migration of the plug by serial tomography.
Similar content being viewed by others
References
Moorman ML, Price PD. Migrating mesh plug: complication of a well-established hernia repair technique. Am Surg 2004;70:298–299.
Inagaki M, Goto J, Okayama T, Suzuki T, Kasai S. “Tension-free” herniorrhaphy for groin hernias in patients with cirrhosis: report of four cases. Surg Today 2009;39:540–543
Benedetti M, Albertario S, Niebel T, Bianchi C, Tinozzi FP, Moglia P, et al. Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report. Hernia 2005;9:93–95.
LeBlanc KA. Complications associated with the plug-and-patch method of inguinal herniorrhaphy. Hernia 2001;5:135–138.
Lo DJ, Bilimoria KY, Pugh CM. Bowel complications after prolene hernia system (PHS) repair: a case report and review of the literature. Hernia 2008;12:437–440.
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J. Surg 1989;157:188–193.
Rutkow IM, Robbins AW. “Tension-free” inguinal herniorrhaphy: a preliminary report on the “mesh plug” technique. Surgery 1993;114:3–8
Dieter RA. Mesh plug migration in scrotum: a new complication of hernia repair. Int Surg 1999;84:57–59.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chen, MJ., Tian, YF. Intraperitoneal migration of a mesh plug with a small intestinal perforation: Report of a case. Surg Today 40, 566–568 (2010). https://doi.org/10.1007/s00595-009-4107-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-009-4107-5