Erosion and perforation of colon by synthetic mesh in a recurrent paracolostomy hernia

Abstract

Parastomal hernia, particularly when recurrent, presents a troublesome problem to the surgeon. Since the late 1970s, prosthetic-mesh repairs have been used increasingly, though, as yet, there is no consensus on the best technique of repair. We report a case of failure of a polypropylene-mesh repair of a recurrent parastomal hernia, complicated by erosion of the mesh edge into the colon proximal to the stoma. This entailed further resection of the colon, excision of the mesh and relocation of the colostomy. The case highlights the potential for serious morbidity from this form of repair and the need for careful assessment of symptoms before contemplating a surgical approach to any type of parastomal hernia.