Recurrent and late esophageal mesh extrusion after paraesophageal hiatoplasty: A case report and review of the literature

• Main Authors: Sonia Fernandez.Ananin, David Sacoto, Carmen Balagué, Carlos Guarner, Eduardo M Targarona
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: International Journal of Abdominal Wall and Hernia Surgery
• Subjects: complications; mesh; paraesophageal hernia; surgical treatment
• Online Access: http://www.herniasurgeryjournal.org/article.asp?issn=2589-8736;year=2020;volume=3;issue=4;spage=158;epage=161;aulast=Fernandez.Ananin

The most accepted management for symptomatic paraesophageal hernias (PEHs) is the closure of the hiatal gap associated with an antireflux procedure. When the defect of the hiatus is particularly wide or the consistency of the pillars is weak, a prosthetic mesh may be used to cover the suture cruroplasty. Nevertheless, the use of mesh in PEHs repair is a subject of ongoing debate, due to the local risk of complications that a foreign body located in this area can lead. We present the case of a 77-year-old female who underwent PEH surgery with placement of polypropylene mesh twice. On both occasions, the prosthesis migrated late through the wall of the esophagus and could be removed by endoscopy. We consider that this case is exceptional, not only due to the multiple and late extrusion of the mesh in the lumen of the esophagus but also due to the absence of symptoms that this event caused to the patient.