An unlikely path: hernia mesh migration A case report

BackgroundMesh migration is one of the most uncommon complications that arise after inguinal hernia repair. Only small case series have been described in the literature and the most frequent locations are bladder, small intestine, cecum, and sigmoid colon. The exact incidence is not yet known. We disclose a particularly relevant case due to the extensive migration path taken.MethodsThe authors present a rare case of mesh migration into the rectal stump of a patient with a history of abdominoperineal amputation with colostomy 19 years and open inguinal hernia repair 10 years previously.ResultsThe remnant mesh fragment was successfully excised by transanal minimally invasive surgery.ConclusionThis case highlights the importance of recognizing and reporting this complication, a phenomenon which can occur at different time intervals after surgery. Reports are heterogeneous but crucial, because mesh migration can lead to a diversity of clinical conditions and potentially serious morbidity. The authors present a distinctive case of complete transluminal migration of a propylene mesh that was initially placed in the preperitoneal space several years before. The minimally invasive surgery performed was successful. Given the high number of these surgical procedures worldwide, a lower diagnostic threshold and reporting of any complication should be encouraged to aid appropriate management and successful treatment.