PDF(Pubmed)
Abstract：
Mesh placement remains the standard of care for inguinal hernioplasty, whether through the classic open approach or the transabdominal preperitoneal (TAPP) approach. Though both techniques are generally safe, they can occasionally result in visceral injuries, albeit infrequently. Mesh migration into the intestines is a morbid situation requiring emergency treatment. We present two male patients who developed mesh-enterocutaneous fistula several years after inguinal hernia repair. The first patient with a history of a bilateral TAPP hernia repair was admitted to the emergency department and underwent bilateral complete mesh removal, limited right colectomy, and wedge resection of the sigmoid colon, due to mesh erosion. The second patient, with a history of a left inguinal hernia treated by open mesh repair, presented to the emergency department complaining of intense pain in his left inguinal area. Erosion of the prosthetic mesh into the sigmoid and a colo-cutaneous fistula was identified, with sigmoidectomy and en bloc excision of the adherent mesh and end-colostomy being performed. Mesh erosion into the intestinal tract is a rare but serious condition. In patients presenting with a subcutaneous abscess in the inguinal region, clinicians should maintain a high level of suspicion for intrabdominal inflammation arising from mesh erosion into adjacent viscera. Surgical management becomes necessary in symptomatic cases or instances of fistulization.
摘要：
网状物放置仍然是腹股沟疝修补术的标准护理，无论是通过经典的开放方法还是经腹腹膜前（TAPP）方法。虽然这两种技术通常都是安全的，它们偶尔会导致内脏损伤，虽然很少。网状物迁移到肠道中是一种需要紧急治疗的病态。我们介绍了两名男性患者，他们在腹股沟疝修补术后几年出现了网状肠皮瘘。首例有双侧TAPP疝修补术史的患者被送往急诊科，并接受了双侧完全网片切除，有限的右结肠切除术,乙状结肠楔形切除术，由于网格侵蚀。第二个病人,具有通过开放网片修复治疗的左腹股沟疝的病史，被送到急诊科，抱怨他的左腹股沟区剧烈疼痛。确定假体网状物侵蚀乙状结肠和皮肤瘘，进行乙状结肠切除术和整块切除粘附网和结肠末造口术。网状侵蚀进入肠道是一种罕见但严重的情况。在腹股沟区域出现皮下脓肿的患者中，临床医师应高度怀疑网片侵蚀邻近脏器引起的腹腔内炎症.在有症状的病例或造瘘的情况下，必须进行手术治疗。
