Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair

Autor: Masatsugu Kuroiwa, Masato Kitazawa, Yusuke Miyagawa, Futoshi Muranaka, Shigeo Tokumaru, Satoshi Nakamura, Makoto Koyama, Yuta Yamamoto, Nao Hondo, Takehito Ehara, Satoru Miyazaki, Hirokazu Tanaka, Yuji Soejima
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Case Reports in Surgery, Vol 2021 (2021)
Druh dokumentu: article
ISSN: 2090-6900
2090-6919
DOI: 10.1155/2021/5683621
Popis: Background. Tension-free repair using mesh has become the standard treatment for abdominal wall incisional hernias. However, its postoperative complications reportedly include mesh infection, adhesions, and fistula formation in other organs. Here, we report an extremely rare case of mesh migration into the neobladder and ileum with entero-neobladder and neobladder-cutaneous fistulas. Case Presentation. An 80-year-old male who had undergone radical cystectomy 5 years ago and abdominal wall incisional hernia repair 3 years ago presented with fever and abdominal pain. Computed tomography (CT) scan revealed mesh migration into the neobladder and ileum. He was treated conservatively with antibiotics for a month but did not show improvement; hence, he was transferred to our hospital. He was diagnosed with mesh migration into the neobladder and ileum with complicated fistula formation. He underwent mesh removal, partial neobladder resection, and partial small bowel resection. He developed superficial incisional surgical site infection, which improved with drainage and antibiotics, and he was discharged 40 days after the surgery. Conclusions. We reported a rare case of mesh migration into the neobladder and ileum with fistula formation. Successful conservative treatment cannot be expected for this condition because mesh migration into the intestinal tract causes infection and fistula formation. Hernia repair requires careful placement of the mesh such that it does not come into contact with the intestinal tract. Early surgical intervention is important if migration into the intestinal tract is observed.
Databáze: Directory of Open Access Journals
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