A Case of Sigmoid Colon Stenosis after Inguinal Hernia Repair with a Mesh Plug

Abstract

A 68-year-old man underwent left inguinal hernia repair with a mesh plug one and a half years ago. Initial surgical findings showed adhesion between the sigmoid colon and hernia sac, which were returned into the abdominal cavity without adhesion detachment and a plug was placed. Abdominal CT showed colon dilatation due to stenosis of the sigmoid colon close to the tip of the plug inserted in the initial surgery. Colonoscopy revealed sigmoid colon stenosis without a neoplastic lesion. Laparoscopic surgery was performed because endoscopic treatment was ineffective. Intraoperative findings showed that the sigmoid colon had strongly adhered to the mesh plug through the peritoneum. After careful adhesion detachment, laparoscopic sigmoidectomy was performed. This case suggests that inguinal hernia repair using a mesh plug can be a risk for intestinal stenosis in a patient with adhesion between the intestine and hernia sac. We discuss the possible mechanism underlying this effect.