Meshoma | Figure 1

reynoso_cirugia

Meshoma

Case Details

Patient: Male in his 50s
Medical history: Incisional abdominal hernia repair with mesh.
Presenting symptoms: Patient reports that the hernia was repaired with a "special" mesh to prevent adhesions. He came because of pain and volume increase in the previous surgery area (image 1).

Preoperative protocol:

• CT scan demonstrated incisional hernia and an apparent meshoma.

Treatment:

• Abdominal wall exploration.
• Explant of previous mesh due to meshoma (image 2).
• Hernia repair with retromuscular mesh.

Postoperative consultation:

• Image 3. postoperative consultation.

Diagnosis:

• Meshoma

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Case 1

Chief Complaint: Midline abdominal bulge and discomfort.
History: Patient with a history of seven prior failed hernia repairs presented with a recurrent midline incisional hernia, associated with progressive bulging and discomfort.
Diagnostic Workup: Abdominal CT scan revealed a ~6 cm midline incisional hernia, with previously placed onlay prosthetic material and evidence of a meshoma.
Diagnosis: Recurrent complex incisional hernia.
Treatment: Abdominal wall reconstruction was performed with left-sided hemi-transversus abdominis release (hemi-TAR), primary midline closure, and placement of a retromuscular polypropylene mesh.
Outcome: The patient had an uneventful postoperative course and was discharged 24 hours after surgery.

Case 2

Description: This scan represents a not so uncommon condition of incisional hernia. Patient had a history of multiple abdominal surgeries and presented with the above and intermittent pain.
Treatment: Repaired with direct closure and absorbable mesh.

Case 3

Patient: Woman in her 50s
Medical History: Open umbilical hernia repair, recurrent umbilical hernia repair by IPOM technique.
Reason for Consultation: Presenting with pain and increased volume in the previous laparoscopic trocar site.
Diagnosis Protocol: Ultrasound with findings consistent with incisional hernia; Abdominal CT Scan with valsalva showing small bowel contents in the hernial sac.
Treatment: Ventral Tapp with mesh; Medium-weight, macroporous polypropylene mesh.