Erosion of small intestine with necrotising fasciitis of over lying abdominal wall after expanded poly-tetrafluoroethylene mesh implantation: A rare complication after laparoscopic incisional hernia repair

Abstract

Complications such as bowel erosions, enterocutaneous fistulae are rare with the use of expandedpoly-tetrafluoroethylene (ePTFE) mesh in laparoscopic incisional hernia repair (LIHR). This unusual case patient presented to us with necrotising fasciitis of overlying anterior abdominal wall with peritonitis withsepticaemia and underwent aLIHR6 weeks before, which has not been reported till yet. We report a case of LIHR, presented to us with necrotising fasciitis of overlying anterior abdominal wall, peritonitis and septicaemia which was managed by small bowel segmental resection and exteriorisation of the ends, debridement of overlying anterior abdominal wall and maximum resection of implanted mesh. This case is unusual secondary to long experience with ePTFE mesh and the lack of published cases similar to this one. A brief review of relevant literature has been included in the article. We recommend pre-peritoneal placement of dual mesh fixed preferably by trans-abdominal polypropylene suture in LIHR.

Keywords

• Bowel erosion
• expandedpoly-tetrafluoroethylene mesh prosthesis
• laparoscopic incisional hernia repair
• necrotising fasciitis