Migration of a mesh into the colon after inguinal hernia repair – a case report

Introduction: Mesh migration is one of the least common complications that arise after inguinal hernia repair with a mesh. Only small case series have been reported, and an understanding of this issue is limited due to a lack of data. Most of the cases were treated surgically. In this paper, we wish to present the potential of treating this condition using endoscopic techniques. Case report: A male patient underwent transabdominal preperitoneal repair of a primary inguinal hernia in 1999. In 2003, the patient required the same procedure for a recurrent inguinal hernia. Twenty years after the primary hernia repair, the patient had a positive faecal occult blood test but was completely asymptomatic. A colonoscopy revealed mesh migration into the sigmoid colon. Despite multiple attempts to remove the mesh endoscopically, endoscopic treatment was unsuccessful. The migrated mesh was surgically removed and obligatory resection of the sigmoid colon was carried out. Apart from wound infection (Clavien-Dindo IIIb), the postoperative course was uneventful. Conclusion: In our case, the mesh that had penetrated the colon could not be removed endoscopically. Despite our experience, it is advisable to attempt endoscopic removal of mesh that has migrated into a hollow intra-abdominal viscus.