|
KMID : 1033020170070020031
|
|
Journal of Hemiology: Diagnosis and Treatment of Hernias
2017 Volume.7 No. 2 p.31 ~ p.34
|
|
|
Occurrence of Enterocutaneous Fistula More Than 40 Years after Prosthetic Mesh Repair for an Umbilical Hernia: A Case Report
|
|
Park Sung-Su
Park Jin-Woo
|
|
|
Abstract
|
|
|
|
A 75-year-old female patient underwent prosthetic mesh repair for an umbilical hernia approximately 40 years ago. She also underwent hysterectomy and appendectomy 30 years ago. She had been well, until she felt periumbilical pain and noticed erythematous swelling 1 month before she visited our hospital. She was admitted to our hospital because of a wound infection. Clinical examination revealed a cutaneous fistula with a minimal amount of purulent discharge along with bowel content from the deep space of the umbilicus. Abdominal computed tomography (CT) revealed an irregularly shaped umbilical mass, measuring 2.6 cm. The CT also revealed a rim-enhancing low-density lesion with internal air bubbles at the anterior abdominal wall; this finding was consistent with that of an abscess. The mass extended intraperitoneally and abutted to the small bowel beneath the umbilicus. An enterocutaneous fistula should be excluded first. Surgical exploration revealed a mesh plug at the fascial defect in the umbilicus and a fistula connection between the abscess and small bowel. En-bloc resection of the mesh plug with small bowel segments, including a fistula opening, was performed. After an end-to-end anastomosis of the small bowel, the peritoneum and fascia were closed in one layer. Delayed primary closure was performed for the operative wound. Postoperative recovery was uneventful, and the patient was discharged after 14 days. The present case showed that prosthetic mesh repair might be a rare cause of developing an enterocutaneous fistula after a long period of normal clinical condition.
|
|
|
KEYWORD
|
|
|
Umbilical hernia, Mesh plug, Enterocutaneous fistula
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|