Case Report: Severe allergic reaction to Physiomesh® after laparoscopic ventral hernia repair

Abstract

Due to a relative high rate of recurrence compared with other meshes for laparoscopic ventral hernia repair, Physiomesh® was recalled in 2016. This case report describes one of two reported cases of allergic reaction after insertion of Physiomesh®. The patient was a 50-year-old male who had a laparoscopic operation for ventral hernia with insertion of Physiomesh® as an intraperitoneal onlay procedure. Two months later, the patient was admitted with intense epigastric pain, and CT scan showed signs of ileus. Emergency surgery was performed revealing severe allergic signs in the abdomen and retroperitoneum. The mesh was removed. The postoperative course was complicated; the patient had multiple admissions with incomplete ileus, as well as recurrence of the ventral hernia. An open sublay hernia repair using a monofilament polyester mesh was subsequently performed with good effect. This case report illustrates a rare complication with mesh insertion. This adverse event adds to the risk of complications following implantation of mesh to reinforce a hernia repair. The allergic reaction was not suspected until during operation. Therefore, this report also illustrates the importance of surgeons’ clinical assessment and ability to take relevant action, which in this case consisted of mesh removal and retrieving tissue samples for histology.