Serious life-threatening complication 5 years after laparoscopic totally extraperitoneal hernia repair: case report and discussion of the literature.

Autor: Gukas ID; Department of Surgery, Frimley Park Hospital NHS Foundation Trust, Frimley, Camberley, Surrey, GU16 7UJ, UK. igukas@hotmail.com, Massouh F
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2011 Aug; Vol. 15 (4), pp. 459-62. Date of Electronic Publication: 2010 May 30.
DOI: 10.1007/s10029-010-0681-0
Abstrakt: Purpose: The purpose of this paper is to report the case of a serious life-threatening infection of the mesh occurring 5 years after totally extraperitoneal (TEP) hernia repair and to highlight the persistent risk of infection that may exist even after a long period following the primary repair. We also aim to raise the awareness of surgeons to the subtle presentation.
Methods: We have reviewed the clinical presentation, past medical history and relevant pre-operative and post-operative investigations in a case of mesh infection 5 years after primary surgery. We have also reviewed the literature regarding long-term complications that may occur after TEP repair.
Results: A 62-year-old man presented with severe mesh infection 5 years and 4 months after primary bilateral TEP hernia repair. He rapidly progressed into septic shock and had to be managed in the intensive care unit. He is a current smoker of 30 pack years. Post-operative contrast computed tomography (CT) revealed previously undiagnosed diverticuli scattered throughout the colon with points of minor narrowing at the sigmoid and transverse colons.
Conclusion: Although the risk of mesh infection following TEP hernia repair is small, it persists for more than 5 years and probably as long as the mesh remains in the body. Our report also raises the question as to whether there is a specific long-term risk of mesh infection following TEP hernia repair in patients with underlying inflammatory bowel disease and/or chronic heavy smoking. This needs to be studied prospectively.
Databáze: MEDLINE
Externí odkaz: