Colonic Penetration after Kugel Patch Inguinal Hernia Repair

Abstract

A 69-year-old man was seen for a lower right abdominal tumor 2 years after right inguinal hernia repair with a Kugel patch. He was operated right inguinal hernia and appendectomy in childhood. Computed tomography (CT) and barium enema examination found to have an abscess formation due to right side colonic diverticulitis. Operative findings showed the cecum strongly adhering to the abdominal wall, with the patch adhering to and penetrating the cecum and forming part of the tumor. The patch was removed and the ileocecum resected. Actinomyces infection was recognized pathologically in the abscess. Despite paralytic ileus and postoperative surgical site infection, the man recovered with conservative treatment. This is, to our knowledge, the first report to demonstrate that colonic penetration after Kugel patch inguinal hernia repair.