Intraperitoneal migration of a mesh plug with a small intestinal perforation: report of a case

Abstract

Tension-free hernia repair with a mesh plug shows a low recurrence rate, but in a very few cases it can result in new complications including mesh migration and violation of the peritoneum. This report describes the case of a 79-year-old man who had undergone an inguinal hernioplasty using a polypropylene mesh plug 2 years earlier. He had a laparotomy for bowel ischemia 18 months later, and no evidence of bowel adhesion or a plug protruding through the peritoneum at that time. The patient remained asymptomatic until this admission. He presented with acute abdomen, and an emergency laparotomy revealed a plug-related bowel perforation. The plug had migrated and penetrated the peritoneum, presenting with bowel perforation and adhesions. Although the etiology was not clear, the use of nonabsorbable sutures for plug fixation may be recommended to avoid this complication. Less than 10 cases of mesh migration with bowel complications have been reported, and this is the first case study to demonstrate migration of the plug by serial tomography.