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

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 i...

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Main Authors: 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
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2021/5683621
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author 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
author_facet 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
author_sort Masatsugu Kuroiwa
collection DOAJ
description 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.
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spelling doaj-art-948fb7774e39492a9124438c2f197a0c2025-02-03T05:45:20ZengWileyCase Reports in Surgery2090-69002090-69192021-01-01202110.1155/2021/56836215683621Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia RepairMasatsugu Kuroiwa0Masato Kitazawa1Yusuke Miyagawa2Futoshi Muranaka3Shigeo Tokumaru4Satoshi Nakamura5Makoto Koyama6Yuta Yamamoto7Nao Hondo8Takehito Ehara9Satoru Miyazaki10Hirokazu Tanaka11Yuji Soejima12Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanDivision of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, JapanBackground. 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.http://dx.doi.org/10.1155/2021/5683621
spellingShingle 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
Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
Case Reports in Surgery
title Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
title_full Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
title_fullStr Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
title_full_unstemmed Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
title_short Mesh Migration into the Neobladder and Ileum with Complicated Fistula Formation following Incisional Hernia Repair
title_sort mesh migration into the neobladder and ileum with complicated fistula formation following incisional hernia repair
url http://dx.doi.org/10.1155/2021/5683621
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