Complete migration of a composite mesh into small bowel incidentally found during laparotomy for colectomy in an asympto
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(2020) 14:207
CASE REPORT
Open Access
Complete migration of a composite mesh into small bowel incidentally found during laparotomy for colectomy in an asymptomatic patient: a case report Pramodh Chandrasinghe1* , Asantha De Silva2, Ayomi Welivita3 and Kemal Deen3
Abstract Background: Composite meshes are used for incisional hernia repair because they enable intraperitoneal mesh placement due to their dorsal surface, which is made of inert material. We report, for the first time, to our knowledge, a case of composite mesh migration detected incidentally during a laparotomy for colon cancer in an asymptomatic patient. Case presentation: Our patient was a 71-year-old South Asian man who underwent ventral mesh repair following a postoperative complication after right hemicolectomy for colon cancer. The patient was diagnosed with a metachronous sigmoid cancer 5 years later, for which he underwent laparotomy. During laparotomy, a migrated mesh was incidentally found and extracted from his proximal ileum without any evidence of abscess or fistula formation. Conclusion: To our knowledge, this is the first report of an incidentally found migrated composite mesh from a bowel lumen in an asymptomatic patient. Keywords: Mesh migration, Composite mesh, Case report, Mesh complications
Background Use of mesh has become standard in a majority of incisional hernia repair to achieve a tension-free repair and reduce recurrence [1]. The composite mesh is designed to reduce the risk of bowel adhering to the mesh by including an absorbable layer to one surface, enabling intraperitoneal mesh placement [2]. It is supposed to reduce complications such as mesh erosion into bowel caused by the use of intraperitoneal polypropylene-only meshes. Reports of mesh migration, both composite and nonabsorbable types, are found in the literature, * Correspondence: [email protected] 1 Department of Surgery, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka Full list of author information is available at the end of the article
although they are always associated with apparent clinical signs and symptoms such as abscess formation, enterocutaneous fistula formation, or bowel obstruction [3, 4]. We report a case of a composite mesh completely migrating into the small bowel found during laparotomy for an unrelated issue.
Case presentation A 71-year-old South Asian man who had under gone a right hemicolectomy for an adenocarcinoma of the colon was found to have a metachronous cancer in the sigmoid colon during surveillance colonoscopy. Following his primary surgery at another institution, he has developed an anastomotic leak during the immediate postoperative period, for which a second laparotomy had
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