Abstract
The patient was an 87-year-old woman who had undergone laparoscopic repair of an abdominal incisional hernia with Composix Mesh (CM) at age 79 (years). Her postoperative course was uneventful, without signs of recurrence. Eight years after surgery, she complained of an exudate and malodor arising from the wound site. Exudation of intestinal fluid from a median fistula in the lower abdomen was observed. Computed tomography revealed adhesion between the CM and the intestine, and fistulography confirmed a communication with the intestine. At laparotomy, it was found that the CM had become folded to form a mass with the surrounding granulation tissue and had adhered to a large part of the intestine which had been penetrated at one point in the process of fistula formation. The CM and the fistula were resected, and the penetrated part of the intestine was sutured to close the wound. The abdominal wall was closed using the components separation technique. Our experience suggests that pathology similar to that of our patient might occur in the future in cases treated using the CM/Composix Kugel Patch. Intra-abdominal mesh fixation must be carefully and innovatively done.
