Mesh migration into the sigmoid colon after inguinal hernia repair presenting as a colonic polyp:A case report and review of literature

作     者：Sha Liu Xin-Xin Zhou Lin Li Mo-Sang Yu Hong Zhang Wei-Xiang Zhong Feng Ji 

作者机构：Department of Gastroenterologythe First Affiliated HospitalCollege of MedicineZhejiang University Department of Pathologythe First Affiliated HospitalCollege of MedicineZhejiang University 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2018年第6卷第12期

页      面：564-569页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Supported by Zhejiang Provincial Natural Science Foundation of China No.LQ16H030001 

主　　题：Colonoscopy Surgical mesh Hernia repair Sigmoid colon Colonic polyps Computed tomography Foreign bodies 

摘      要：Mesh migration and penetration into abdominal visce-ra rarely occur after laparoscopic inguinal hernia repair. We present the first case of mesh migration into the sigmoid colon identified as a colonic polyp at initial co-lonoscopic examination. The patient complained of mild abdominal distention in the lower abdomen over the previous year without changes in bowel habits or stool appearance and without weight loss. By complement-ary endoscopic ultrasonography, a cavity--like structure beneath the suspected polyp was further confirmed. Enhanced abdominal computed tomography merely re-vealed local bowel wall thickening and inflammation of the colosigmoid junction. The migrating mesh, which was lodged in the sigmoid colon and caused intra--abdomi-nal adhesion in the lower abdominal cavity, was finally identified via exploratory surgery. The components of inflammatory granulation tissue around the mesh mate-rial were diagnosed based on histological examination of the surgical specimen after sigmoidectomy. In this patient, nonspecific endoscopic and imaging outcomes during clinical work--up led to the diagnostic dilemma of mesh migration. Therefore, the clinical, radiological and endoscopic challenges specific to this case as well as the underlying reasons for mesh migration are discussed in detail.