Small bowel obstruction by mesh migration after umbilical hernia repair

Abstract

A case of intestinal obstruction due to mesh migration is described. A 61 year old patient affected by BPCO and chronic atrial fibrillation is admitted for mechanical intestinal obstruction. He underwent a umbilical hernia repair with mesh and omphalectomy 6 years before. Laparotomy revealed the obstruction due to an inflammatory block including polypropylene mesh penetrating an ileal loop. Intestinal resection and mechanical isoperistaltic L-L anastomosis is performed. The post-operative period is complicated by cardiorespiratory problems and the patient comes discharged in XVII day. The prosthesis migration after umbilical hernia repair is an event never described in the literature; instead rare cases of migration after inguinal hernia repair are reported. The pathophysiological mechanisms of this complication are not still cleared and that makes necessary a careful technique in the use of the hernia mesh.