Abstract
Enterocutaneous fistula following mesh repair of incisional hernia is usually due to mesh erosion of the underlying viscus and presents late. We describe an early enterocutaneous fistula due to an unusual but a potential mode of bowel injury during mesh fixation. This case is reported to emphasize the need for greater attention to the technique of mesh fixation. We suggest laparoscopic guidance to prevent this serious complication in lateral Incisional hernias with ill defined edges of the defect.
Highlights
Enterocutaneous fistula is a late complication of mesh repair of incisional hernia and is usually due to erosion of intestines by the mesh
We present our experience with an enterocutaneous fistula due to anchoring stitch resulting in bowel injury during mesh fixation in an onlay repair of a lateral Incisional hernia
The incisional hernia was repaired by onlay meshplasty using a polypropylene mesh (6" × 6") and the mesh was anchored to the aponeurosis beyond the defect with polypropylene sutures
Summary
Enterocutaneous fistula is a late complication of mesh repair of incisional hernia and is usually due to erosion of intestines by the mesh. Development of enterocutaneous fistula is usually due to inadvertent and unrecognized enterotomy during separation of adhesions. We present our experience with an enterocutaneous fistula due to anchoring stitch resulting in bowel injury during mesh fixation in an onlay repair of a lateral Incisional hernia. Ill defined edges of the hernial defect and bowel adherent to the sac were the cause of this complication.
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