Mesh expansion as the cause of bulging after abdominal wall hernia repair. (2016)

• Record Type: Journal Article
• Authors: Deerenberg, E.B.; Verhelst, J.; Hovius, S.E.R.; Lange, J.F.
• Is Part Of: International journal of surgery case reports. Volume 28(2016)
• Page Start: 200
• Page End: 203
• Publication Date: 2016
• Subjects: Abdominal wall reconstruction -- Bulging -- Recurrence -- Mesh -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.09.051
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Swelling of the abdominal wall after abdominal wall reconstruction can be caused by a recurrence or bulging of the mesh. CT-scan can be useful to distinguish between a true recurrence or bulging of the mesh. Bulging of a mesh can be caused by pore enlargement and expansion of the mesh. The distinction between a recurrence and bulging of the mesh is therapeutically irrelevant in symptomatic patients. Mesh characteristics should be considered when choosing a feasible and suitable mesh for abdominal wall reconstruction. Abstract: Background: Recurrence is the most important complication of abdominal wall reconstruction. It is possible the repair itself is intact, but bulging or expansion of mesh causes recurrent swelling's of the abdominal wall. Case summary: In this report, we present bulging of a polyester mesh due to central pore expansion. Discussion: Repetitive stress and variations in intra-abdominal pressure can change tensile strength and stretches mesh materials. Conclusion: A swelling after abdominal wall repair can be caused by bulging of the mesh. A progressive bulging might be the result of failure of the mesh implant due to elongation. Mesh characteristics should be considered when choosing a feasible and suitable mesh for abdominal wall reconstruction. Clinical distinction between recurrent hernia and mesh bulging is difficult but therapeutically irrelevant in symptomatic patients.